Mini-Cog Performance: Novel Marker of Post Discharge Risk Among Patients Hospitalized for Heart Failure
Abstract
Background—: Heart failure (HF) guidelines recommend screening for cognitive impairment (CI) but do not identify how. The Mini-Cog is an ultrashort cognitive “vital signs” measure that has not been studied in patients hospitalized for HF. The purpose of this study was to evaluate whether CI as assessed by the Mini-Cog is associated with increased readmission or mortality risk after hospitalization for HF. Methods and Results—: We analyzed 720 consecutive patients who completed the Mini-Cog as a part of routine clinical care during hospitalization for HF. Our primary outcome was time between hospital discharge and first occurrence of readmission or mortality. There was a high prevalence of CI as quantified by Mini-Cog performance (23% of cohort). During a mean follow-up time of 6 months, 342 (48%) patients were readmitted, and 24 (3%) died. Poor Mini-Cog performance was an independent predictor of composite outcome (adjusted hazard ratio, 1.90; 95% confidence interval, 1.47–2.44; P <0.0001) and was identified as the most important predictor among 55 variables by random survival forest analysis. Inclusion of Mini-Cog performance in risk models improved accuracy (bootstrapped c -index, 0.602 versus 0.624) and risk reclassification (category-free net reclassification improvement, 27%; 95% confidence interval, 14%–40%; P <0.001). Secondary analysis of initial 30 days post discharge showed effect modification by venue of discharge, whereby patients with CI discharged to a facility had longer time to outcome as compared with those discharged home. Conclusions—: Mini-Cog performance is a novel marker of posthospitalization risk. Discharge to facility rather than home may be protective for those patients with HF and CI. It is unknown whether structured in-home support would yield similar outcomes.
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Individuals hospitalized with heart failure are more likely to be readmitted or die after hospital discharge if they also have cognitive impairment.
“One research team found that individuals hospitalized with heart failure are more likely to be readmitted or die after hospital discharge if they also have cognitive impairment.792”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [792]
Individuals hospitalized with heart failure were more likely to be readmitted or die after hospital discharge if they also had cognitive impairment.
“One research team found that individuals hospitalized with heart failure were more likely to be readmitted or die after hospital discharge if they also had cognitive impairment. 952”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [952]
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- Authors
- Patel, A., Parikh, R., Howell, E. H., Hsich, E., Landers, S. H., & Gorodeski, E. Z.
- Affiliations
- Rutgers, The State University of New Jersey (US)
- Venue
- Circulation: Heart Failure
- Published
- 2015-01
- Volume
- 8
- Issue
- 1
- Pages
- 8-16
- ISSN
- 1941-3289 (ISSN-L)
- 1941-3297
- OpenAlex
- W2548933680
- Cited by
- 133
- References
- 36
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 14 · 2023: 13 · 2022: 13 · 2021: 9 · 2020: 11 · 2019: 14 · 2018: 9 · 2017: 10 · 2016: 14 · 2015: 3
- FWCI
- 6.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- heart failure, cognitive impairment, Mini-Cog, cognitive screening, hospital readmission, mortality, risk prediction model, discharge disposition
- MeSH terms
- Aged, Aged, 80 and over, Cognition, Female, Follow-Up Studies, Heart Failure, Humans, Inpatients, Male, Patient Discharge, Prognosis, Prospective Studies, Registries, Risk Factors, United States, Incidence, Prevalence, Survival Rate, Risk Assessment, Cognitive Dysfunction
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