{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Kim M"],"funding":["National Institute of Neurological Disorders and Stroke","National Center for Advancing Translational Sciences","Northwestern University Feinberg School of Medicine","NCATS NIH HHS","Foundation for the National Institutes of Health","NINDS NIH HHS","Feinberg School of Medicine"],"pagination":["2282-2290"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC6856598"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["6(11)"],"pubmed_abstract":["<h4>Objective</h4>Cognitive impairment, detected in up to 80% of patients with liver cirrhosis, is associated with negative health outcomes but is underdiagnosed in the clinical setting due to the lack of practical testing method. This single-center prospective observational study aimed to test the feasibility and prognostic utility of in-clinic cognitive assessment of patients with liver cirrhosis using the NIH Toolbox cognition battery (NIHTB).<h4>Methods</h4>Patients recruited from a hepatology/transplant clinic underwent cognitive assessments using West-Haven Grade (WHG) and NIHTB between November 2016 and August 2018 and were prospectively followed until December 2018. The primary outcome was a composite end point of hospitalization related to overt hepatic encephalopathy (OHE) and all-cause mortality during follow-up, evaluated by a Cox proportional hazards regression model that adjusted for a priori covariates (age and MELD-Na).<h4>Results</h4>Among 127 patients (median age 60 years, 48 [38%] women) assessed, cognitive performance was significantly impaired in 82 [78%] patients with WHG 0 and 22 [100%] patients with WHG 1 and 2. Over a median of 347 days follow-up, 18 OHE and 8 deaths were observed. Lower cognitive performance was associated with an increased risk of OHE/death adjusting for age and MELD-Na. Subclinical cognitive impairment detected by NIH Toolbox in WHG 0 patients was significantly associated with greater mortality. Median time to complete the two prognostically informative NIH Toolbox tests was 9.4 min.<h4>Interpretation</h4>NIH Toolbox may enable a rapid cognitive screening in the outpatient setting and identify patients at high risk for death and hospitalization for severe encephalopathy."],"journal":["Annals of clinical and translational neurology"],"pubmed_title":["Impaired cognition predicts the risk of hospitalization and death in cirrhosis."],"pmcid":["PMC6856598"],"funding_grant_id":["L30 NS098427","L30 NS080176","K23NS092975","UL1 TR001422","KL2TR001424","L30NS080176","R01 NS110779","L30NS098427","R01NS085002","R01 NS085002","K23 NS092975","KL2 TR001424"],"pubmed_authors":["Peipert JD","Sorond FA","Naidech AM","Prabhakaran S","Liotta EM","Zee PC","Ladner DP","Kim M","Maas MB","Ganger DR","Karmarkar A","Reid KJ"],"additional_accession":[]},"is_claimable":false,"name":"Impaired cognition predicts the risk of hospitalization and death in cirrhosis.","description":"<h4>Objective</h4>Cognitive impairment, detected in up to 80% of patients with liver cirrhosis, is associated with negative health outcomes but is underdiagnosed in the clinical setting due to the lack of practical testing method. This single-center prospective observational study aimed to test the feasibility and prognostic utility of in-clinic cognitive assessment of patients with liver cirrhosis using the NIH Toolbox cognition battery (NIHTB).<h4>Methods</h4>Patients recruited from a hepatology/transplant clinic underwent cognitive assessments using West-Haven Grade (WHG) and NIHTB between November 2016 and August 2018 and were prospectively followed until December 2018. The primary outcome was a composite end point of hospitalization related to overt hepatic encephalopathy (OHE) and all-cause mortality during follow-up, evaluated by a Cox proportional hazards regression model that adjusted for a priori covariates (age and MELD-Na).<h4>Results</h4>Among 127 patients (median age 60 years, 48 [38%] women) assessed, cognitive performance was significantly impaired in 82 [78%] patients with WHG 0 and 22 [100%] patients with WHG 1 and 2. Over a median of 347 days follow-up, 18 OHE and 8 deaths were observed. Lower cognitive performance was associated with an increased risk of OHE/death adjusting for age and MELD-Na. Subclinical cognitive impairment detected by NIH Toolbox in WHG 0 patients was significantly associated with greater mortality. Median time to complete the two prognostically informative NIH Toolbox tests was 9.4 min.<h4>Interpretation</h4>NIH Toolbox may enable a rapid cognitive screening in the outpatient setting and identify patients at high risk for death and hospitalization for severe encephalopathy.","dates":{"release":"2019-01-01T00:00:00Z","publication":"2019 Nov","modification":"2024-12-04T12:06:12.754Z","creation":"2020-05-21T21:37:36Z"},"accession":"S-EPMC6856598","cross_references":{"pubmed":["31631586"],"doi":["10.1002/acn3.50924"]}}