Mini-Cog Performance: A Novel Marker of Post-Discharge Risk Among XXXX Hospitalized for Heart Failure.

@entity1 @entity73
BACKGROUND: -HF guidelines recommend screening for @entity73 ( @entity73 ) but do not identify how. The Mini-Cog is an ultra-short cognitive 'vital signs' measure that has not been studied in @entity1 hospitalized for HF. The purpose of this study was to evaluate whether @entity73 as assessed by the Mini-Cog is associated with increased readmission or mortality risk following hospitalization for HF. METHODS AND RESULTS: -We analyzed 720 consecutive @entity1 who completed the Mini-Cog as 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 @entity73 as quantified by Mini-Cog performance (23% of cohort). During a mean follow up time of 6 months, 342 (48%) @entity1 were readmitted, and 24 (3%) died. Poor Mini-Cog performance was an independent predictor of composite outcome (adjusted HR 1.90, 95% @entity73 1.47-2.44, P<.0001), and was identified as 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 vs. 0.624) and risk reclassification (category-free NRI 27%, 95% @entity73 14%-40%, P<.001). Secondary analysis of initial 30-days post-discharge showed effect modification by venue of discharge, whereby @entity1 with @entity73 discharged to a facility had longer time to outcome as compared with those discharged home. CONCLUSIONS: -Mini-Cog performance is a novel marker of post-hospitalization risk. Discharge to facility rather than home may be protective for those HF @entity1 with @entity73 . It is unknown if structured in-home support would yield similar outcomes.
