P12 Longterm outcomes for alcohol related cognitive impairment (ARCI) in an acute hospital setting
Notice bibliographique
Résumé
<h3></h3> Excess alcohol can cause neuro-cognitive impairment. There is a paucity of outcome data for patients with alcohol-related cognitive impairment (ARCI). This study used the Montreal Cognitive Assessment (MoCA) as a screening tool to detect ARCI and retrospectively assess survival outcomes at 2 and 5 years. Patients identified as at risk of ARCI had an initial MOCA (iMoCA) performed by the alcohol care team. A database for patients who met screening criteria was created. NHS Spine was inbuilt, to update individual mortality (in days) from iMOCA. It was closed at 5 years from the final entrant and a retrospective review of electronic records was performed. Of the 210 patients who met screening criteria for ARCI; majority (144) were male, mean age was 52 (26–80) and 149 (70.9%) had no underlying Chronic Liver Disease (CLD). 109 (51.9%) patients had an abnormal iMoCA with 74 (35%) scoring <24. Of these 74, 26 (35.1%) died within 2 years compared with 25 (24.8%) of patients with MoCA >24. Subgroup analysis found 16/49 (32.7%) of patients with no-CLD and low iMoCA died within 2 years, compared with 19/74 (25.7%) in the no-CLD and normal iMoCA group. 10/25 (40%) of patients with low iMoCA and CLD died within 2 years, compared with 6/27 (22.2%) who had normal iMoCA and CLD. Mortality at 5years for low iMoCA + no-CLD was 24/49 (49%) which was similar to normal iMoCA + CLD 14/27 (51.9%). For non-cirrhotics, survival outcomes were better at 2 years if iMoCA <24 and any MoCA follow up recorded. p value of 0.01 (graph 1). For those who showed cognitive recovery with serial MoCA, there was no demonstrable survival benefit during the follow up period. Despite the limitations of this study there are important messages that have not been previously recorded. There is a clear relationship, 10.3% difference, between early mortality (defined as 2 years) and low iMoCA, particularly in those with co-existent CLD. We have also identified a statistically significant survival benefit in the non-cirrhotics who received ARCI follow up. There is a lack of recognition of ARCI and minimal services currently available to patients. Overall poor outcomes, but improvement for those engaging with services, underscores the need for further research in this area and crucially, the ongoing development of new models of care.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».