Pre-transplant cognitive screening is a poor predictor of post-transplant cognitive status.

Pre-transplant cognitive screening is a poor predictor of post-transplant cognitive status.
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DOI:
10.1111/ctr.14798
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发表时间:
2022-11
影响因子:
2.1
通讯作者:
--
中科院分区:
医学3区
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--
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移植中心对于移植患有认知障碍的患者犹豫不决。目前尚不清楚肾移植前 (KT) 认知筛查是否可以预测 KT 后认知功能。我们通过蒙特利尔认知评估 (MoCA) 对 108 名患者进行 KT 前后的认知功能评估。我们使用调整后的逻辑回归模型来评估 KT 前后认知状态的变化(连续变量),并使用线性混合模型来评估 KT 前后 MoCA 评分(分类变量)的变化。 KT 前和后的平均 MoCA 分数分别为 25.3±3.0 和 26.4±2.8。最终 KT 前评分并不能预测 KT 后认知状态(OR = 1.08;95% CI:0.92–1.26;p = 0.35)。最终 KT 前评分≥26 的患者中有 32% 至少有一项 KT 后评分<26。相反,最终 KT 前评分 <26 的患者中,61% 至少有一项 KT 后评分≥26。在线性混合模型分析中,最终的 KT 前评分与 KT 后评分的微小、临床上不显着的影响(β = 0.34;95% CI:0.19–0.49;p < 0.001)相关。 KT 前 MoCA 评分低并不是 KT 后认知功能的强有力的独立预测因子,不应妨碍患者接受 KT。
Transplant centers hesitate to transplant patients with cognitive impairment. It is unclear if pre-kidney transplant (KT) cognitive screening can predict post-KT cognitive function. We evaluated pre-to post-KT cognitive function with the Montreal Cognitive Assessment (MoCA) in a cohort of 108 patients. We used an adjusted logistic regression model to assess pre- to post-KT changes in cognitive status (continuous variable) and a linear mixed model to assess changes in MoCA scores (categorical variable) pre- to post- KT. The average pre- and post-KT MoCA scores were 25.3±3.0 and 26.4±2.8 respectively. Final pre-KT score did not predict post-KT cognitive status (OR = 1.08; 95% CI: 0.92–1.26; p = 0.35). 32% of the patients with a final pre-KT score ≥26 had at least one post-KT score <26. Conversely, 61% of the patients with a final pre-KT score <26 had at least one post KT score ≥26. In the linear mixed model analysis, the final pre-KT score was associated with a small, clinically insignificant (β = 0.34; 95% CI: 0.19–0.49; p < 0.001) effect on the post-KT score. A low pre-KT MoCA score is not a strong independent predictor of post-KT cognitive function and should not preclude patients from receiving a KT.
DOI: 10.1053/j.ajkd.2016.11.015
发表时间: 2017-06
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