Faculty Collaboration Database

Identifying self-reported neurocognitive deficits in the adult with congenital heart disease using a simple screening tool. Congenit Heart Dis 2018 Sep;13(5):728-733

Date

08/02/2018

Pubmed ID

30066452

DOI

10.1111/chd.12646

Scopus ID

2-s2.0-85051143028 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

OBJECTIVE: Children with congenital heart disease (CHD) and adults with acquired heart disease are at an increased risk of neurocognitive impairment. The objective of this study was to determine the prevalence of self-reported neurocognitive impairment and its risk factors in the adult congenital heart disease (ACHD) population.

DESIGN: The Wisconsin Adult Congenital Heart Disease Program recently began screening ACHD patients to identify those with significant self-perceived neurocognitive impairments. Screening consists of using a validated neuro-oncology screening instrument that has been modified for the ACHD population. Patients who answer this survey in a predetermined fashion consistent with significant self-perceived neurocognitive deficits are referred for a formal neurocognitive evaluation. Demographic and clinical information are obtained by chart review.

RESULTS: Three hundred ten patients (49% males) completed the screening process. The average age was 30 years (range: 17-69 years). For the cohort, 57 (18%) patients had no prior cardiac surgeries, 85 (28%) one surgery, 77 (25%) two, and 91 (29%) at least three surgeries. Of those screened, 106 (34%) met criteria for a formal neurocognitive evaluation. Patients who were referred had undergone a greater number of prior cardiac surgeries (2.2 vs 1.7, P = .008) and were more likely to have severe complexity CHD (P = .006). Of those patients who were referred, the worst perceived functioning was in math and attention.

CONCLUSION: There is a high prevalence of ACHD patients with significant self-perceived neurocognitive deficits. Simple screening questionnaires may help identify those patients at high risk and allow for timely and appropriate referral for formal neurocognitive evaluation, diagnosis, and therapy.

Author List

Brunmeier A, Reis MP, Earing MG, Umfleet L, Ginde S, Bartz PJ, Cohen S

Authors

Peter J. Bartz MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin
Scott B. Cohen MD Associate Professor in the Medicine department at Medical College of Wisconsin
Salil Ginde MD, MPH Associate Professor in the Pediatrics department at Medical College of Wisconsin
Laura Umfleet PsyD Associate Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Attention
Cognition
Cognition Disorders
Cross-Sectional Studies
Female
Follow-Up Studies
Heart Defects, Congenital
Humans
Male
Neuropsychological Tests
Prevalence
Retrospective Studies
Self Report
Severity of Illness Index
Surveys and Questionnaires
Time Factors
Wisconsin