TY - JOUR
T1 - The Montreal Cognitive Assessment is a valid Cognitive Screening Tool for Cardiac Arrest Survivors
AU - van Gils, Pauline
AU - van Heugten, Caroline
AU - Hofmeijer, Jeannette
AU - Keijzer, Hanneke
AU - Nutma, Sjoukje
AU - Duits, Annelien
N1 - Funding Information:
The authors thank Roos Roberts, Marlies van Wijk, Rachel ter Bekke, Zafer Geijk for helping with data collection and recruiting patients the MUMC, Ilja Klabbers and Lieke Teunisen for performance of NPA in the Radboudumc and Rijnstate hospital, respectively, and Karen Meeske, Bonita van Es, Elise Rooijakkers, Joy Grotenhuis and Mandy Helmstrijd for performance of NPA in Medisch Spectrum Twente. Jeannette Hofmeijer is supported by a clinical established investigator grant of the Dutch Heart Foundation (Grant Number 2018T070).
Funding Information:
The authors thank Roos Roberts, Marlies van Wijk, Rachel ter Bekke, Zafer Geijk for helping with data collection and recruiting patients the MUMC, Ilja Klabbers and Lieke Teunisen for performance of NPA in the Radboudumc and Rijnstate hospital, respectively, and Karen Meeske, Bonita van Es, Elise Rooijakkers, Joy Grotenhuis and Mandy Helmstrijd for performance of NPA in Medisch Spectrum Twente. Jeannette Hofmeijer is supported by a clinical established investigator grant of the Dutch Heart Foundation (Grant Number 2018T070 ).
Publisher Copyright:
© 2022 The Authors
PY - 2022/3
Y1 - 2022/3
N2 - AIM: The survival rate of out-of-hospital cardiac arrest (OHCA) patients has increased over the past decades. This gives rise to a growing number of patients with hypoxic-ischemic brain damage and cognitive impairment. Currently, cognitive impairment is underdiagnosed in OHCA patients. There is a need for a validated cognitive screening instrument to identify patients with cognitive impairment. This study aimed to examine the diagnostic value of the Montreal Cognitive Assessment (MoCA) in patients after OHCA.METHODS: Survivors (age ≥18 years) of OHCA completed the MoCA and a gold standard neuropsychological test battery, including tests for memory, attention, perception, language, reasoning, and executive functioning, at around one year after OHCA. Results of the MoCA are related to the results of the neuropsychological test battery. Analyses of diagnostic accuracy included receiver operating characteristics and calculation of predictive values.RESULTS: We included 54 OHCA survivors (mean age = 57.3, 74% male). The area under the curve (AUC) was 0.8, 95% CI [0.67, 0.93]. The MoCA showed excellent sensitivity of 86%, 95% CI [57, 98] and adequate specificity of 70.0%, 95% CI [53, 83] to detect cognitive impairment at the regular cut-off score of 26. The positive predictive value of the MoCA was 50%, 95% CI [30, 70] and the negative predictive value was 93%, 95% CI [76, 99].CONCLUSION: This study shows that the MoCA may be a valid cognitive screening instrument for use in the OHCA patient population.
AB - AIM: The survival rate of out-of-hospital cardiac arrest (OHCA) patients has increased over the past decades. This gives rise to a growing number of patients with hypoxic-ischemic brain damage and cognitive impairment. Currently, cognitive impairment is underdiagnosed in OHCA patients. There is a need for a validated cognitive screening instrument to identify patients with cognitive impairment. This study aimed to examine the diagnostic value of the Montreal Cognitive Assessment (MoCA) in patients after OHCA.METHODS: Survivors (age ≥18 years) of OHCA completed the MoCA and a gold standard neuropsychological test battery, including tests for memory, attention, perception, language, reasoning, and executive functioning, at around one year after OHCA. Results of the MoCA are related to the results of the neuropsychological test battery. Analyses of diagnostic accuracy included receiver operating characteristics and calculation of predictive values.RESULTS: We included 54 OHCA survivors (mean age = 57.3, 74% male). The area under the curve (AUC) was 0.8, 95% CI [0.67, 0.93]. The MoCA showed excellent sensitivity of 86%, 95% CI [57, 98] and adequate specificity of 70.0%, 95% CI [53, 83] to detect cognitive impairment at the regular cut-off score of 26. The positive predictive value of the MoCA was 50%, 95% CI [30, 70] and the negative predictive value was 93%, 95% CI [76, 99].CONCLUSION: This study shows that the MoCA may be a valid cognitive screening instrument for use in the OHCA patient population.
KW - Cardiac arrest
KW - Cognitive impairment
KW - Montreal Cognitive Assessment tool
KW - Cognitive screening tool
KW - QUALITY-OF-LIFE
KW - IMPAIRMENT
KW - MOCA
U2 - 10.1016/j.resuscitation.2021.12.024
DO - 10.1016/j.resuscitation.2021.12.024
M3 - Article
C2 - 34958880
SN - 0300-9572
VL - 172
SP - 130
EP - 136
JO - Resuscitation
JF - Resuscitation
ER -