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计算机认知老年评估系统-屏幕(CoSAS-S)在脓毒症危重症患者中的可行性研究。

The feasibility study of Computer Cognitive Senior Assessment System-Screen (CoSAS-S) in critically ill patients with sepsis.

机构信息

Rehabilitation and Participation Science, Program in Occupational Therapy, Washing University School of Medicine in St. Louis, MO, USA.

Department of Rehabilitation Medicine, Chungnam National University Hospital, School of Medicine, Chungnam National University, Daejeon, Republic of Korea.

出版信息

J Crit Care. 2018 Apr;44:128-133. doi: 10.1016/j.jcrc.2017.10.005. Epub 2017 Oct 10.

DOI:10.1016/j.jcrc.2017.10.005
PMID:29096231
Abstract

PURPOSE

Early cognitive assessment in the intensive care unit (ICU) is essential to monitor cognitive dysfunction after critical illness. We have implemented a Computer Cognitive Senior Assessment System-Screen (CoSAS-S) which is a brief, objective, and tablet-based cognitive screening test as a mobile platform to detect any cognitive problems in ICUs. This study aimed to evaluate the feasibility and initial validation of a tablet-based CoSAS-S in critically ill patients with sepsis.

MATERIALS AND METHODS

Thirty-six eligible patients completed CoSAS-S, Mini-Mental State Examination-Korean Version (MMSE-K) and Korean Version of Montreal Cognitive Assessment (K-MoCA) for validity testing at the ICU.

RESULTS

Eighty-eight percent of programmed assessments were completed by the sample. Spearman correlations of the CoSAS-S with MMSE-K (rho=0.613-0.874, p<0.00) and K-MoCA scores (rho=0.666-0.897, p<0.001) were moderate to high. Intra-class correlation coefficient (ICC) of total CoSAS-S score between two raters was 0.93 (p<0.001; 95% CI=0.82-0.97), suggesting the inter-rater reliability of CoSAS-S was excellent.

CONCLUSIONS

Support was found for the feasibility and validity of CoSAS-S. The application of CoSAS-S could identify the cognitive functioning of the patients. Utility of CoSAS-S in other clinical populations should be tested.

摘要

目的

在重症监护病房(ICU)进行早期认知评估对于监测重症疾病后的认知功能障碍至关重要。我们已经实施了计算机认知高级评估系统-屏幕(CoSAS-S),这是一种简短、客观、基于平板电脑的认知筛查测试,作为移动平台,用于检测 ICU 中的任何认知问题。本研究旨在评估基于平板电脑的 CoSAS-S 在患有败血症的危重病患者中的可行性和初步验证。

材料和方法

36 名符合条件的患者在 ICU 完成了 CoSAS-S、简易精神状态检查-韩国版(MMSE-K)和蒙特利尔认知评估韩国版(K-MoCA)的有效性测试。

结果

样本中完成了 88%的编程评估。CoSAS-S 与 MMSE-K(rho=0.613-0.874,p<0.00)和 K-MoCA 评分(rho=0.666-0.897,p<0.001)之间的 Spearman 相关性为中度至高度。两位评分者之间总 CoSAS-S 评分的组内相关系数(ICC)为 0.93(p<0.001;95%置信区间=0.82-0.97),表明 CoSAS-S 的组内信度极好。

结论

支持 CoSAS-S 的可行性和有效性。CoSAS-S 的应用可以识别患者的认知功能。应在其他临床人群中测试 CoSAS-S 的效用。

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