Author + information
- Scott Cohen,
- Ashley Leverenz,
- Michael Reis,
- Laura Umfleet,
- Salil Ginde,
- Peter Bartz and
- Michael Earing
Background: Children with congenital heart disease (CHD) and adults with acquired heart disease are at an increased risk of neurocognitive impairment. The prevalence of neurocognitive impairment and its risk factors in the adult congenital heart disease (ACHD) population is not well described.
Methods: The Wisconsin Adult Congenital Heart Disease (WAtCH) Program recently began screening ACHD patients to identify those at high risk of having neurocognitive impairments. Screening consists of using a validated neuro-oncology screening instrument that has been modified for the ACHD population. It consists of 10 questions answered on a Likert scale that measure a subject's self perceived competence in 8 neurocognitive domains (attention, memory, language, executive functioning, independence in activities of daily living, math, processing speed and reading). Patients who answer this survey in a predetermined high risk fashion are then referred for a formal neurocognitive evaluation. Demographic information, type of CHD, number of surgeries and medications at the time of the survey are obtained by chart review.
Results: In the pilot phase of the neurocognitive screening program 310 patients (49% males) completed the screening process. The average age of patients who underwent screening 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 the high risk criteria for a formal neurocognitive evaluation. Patients who met the high risk criteria had undergone a greater number of prior cardiac surgeries (2.2 vs 1.7, p=0.008) and were more likely to have severe complexity CHD (p=0.006). Of those patients that met the high risk criteria, the neurocognitive domains in which they had the worst perceived functioning were math and attention.
Conclusions: Our pilot data, confirms there is a high prevalence of ACHD patients that qualify for neurocognitive testing. 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.
Moderated Poster Contributions
Congenital Heart Disease and Pulmonary Hypertension Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 11:15 a.m.-11:25 a.m.
Session Title: Congenital Heart Disease: To the Third Decade and Beyond
Abstract Category: 9. Congenital Heart Disease: Adult
Presentation Number: 1131M-13
- 2017 American College of Cardiology Foundation