Barriers to cognitive screening in acute stroke units

Abstract Cognitive impairment is common after stroke. However, not all patients with stroke undergo cognitive screening, despite recommendations. The aim of this retrospective, explorative study was to examine the barriers to cognitive screening in acute stroke units. Data were retrieved from two Sw...

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Autores principales:	Tamar Abzhandadze, Dongni Buvarp, Åsa Lundgren-Nilsson, Katharina S. Sunnerhagen
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/cf7f165ea6ef40e7952a57e782d01c98
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spelling	oai:doaj.org-article:cf7f165ea6ef40e7952a57e782d01c982021-12-02T16:56:43ZBarriers to cognitive screening in acute stroke units10.1038/s41598-021-98853-52045-2322https://doaj.org/article/cf7f165ea6ef40e7952a57e782d01c982021-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98853-5https://doaj.org/toc/2045-2322Abstract Cognitive impairment is common after stroke. However, not all patients with stroke undergo cognitive screening, despite recommendations. The aim of this retrospective, explorative study was to examine the barriers to cognitive screening in acute stroke units. Data were retrieved from two Swedish Stroke registries. The outcome variable was cognitive screening during the stay at acute stroke units. Forty-three candidate explanatory variables were considered for analysis, encompassing sociodemographic factors and stroke-related outcomes during the stay at acute stroke units. The Least Absolute Shrinkage and Selection Operator and decision-tree methods were used. Of the 1120 patients (56% male, mean age: 72 years, 50% with mild stroke), 44% did not undergo cognitive screening. Walking 10 m post-stroke was the most important attribute for decisions regarding cognitive screening. The classification accuracy, sensitivity, and specificity of the model were 70% (95% CI 63–75%), 71% (63–78%), and 67% (55–77%), respectively. Patient-related parameters that influenced cognitive screening with a valid and reliable screening instrument in acute stroke units included new stroke during the hospitalisation, aphasia at admission, mobility problems, impaired verbal output skills, and planned discharge to another care facility. The barriers to cognitive screening were both patient- and organisation-related, suggesting the need for patient-tailored cognitive screening tools as well as the implementation and systematic adherence to guidelines.Tamar AbzhandadzeDongni BuvarpÅsa Lundgren-NilssonKatharina S. SunnerhagenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tamar Abzhandadze Dongni Buvarp Åsa Lundgren-Nilsson Katharina S. Sunnerhagen Barriers to cognitive screening in acute stroke units
description	Abstract Cognitive impairment is common after stroke. However, not all patients with stroke undergo cognitive screening, despite recommendations. The aim of this retrospective, explorative study was to examine the barriers to cognitive screening in acute stroke units. Data were retrieved from two Swedish Stroke registries. The outcome variable was cognitive screening during the stay at acute stroke units. Forty-three candidate explanatory variables were considered for analysis, encompassing sociodemographic factors and stroke-related outcomes during the stay at acute stroke units. The Least Absolute Shrinkage and Selection Operator and decision-tree methods were used. Of the 1120 patients (56% male, mean age: 72 years, 50% with mild stroke), 44% did not undergo cognitive screening. Walking 10 m post-stroke was the most important attribute for decisions regarding cognitive screening. The classification accuracy, sensitivity, and specificity of the model were 70% (95% CI 63–75%), 71% (63–78%), and 67% (55–77%), respectively. Patient-related parameters that influenced cognitive screening with a valid and reliable screening instrument in acute stroke units included new stroke during the hospitalisation, aphasia at admission, mobility problems, impaired verbal output skills, and planned discharge to another care facility. The barriers to cognitive screening were both patient- and organisation-related, suggesting the need for patient-tailored cognitive screening tools as well as the implementation and systematic adherence to guidelines.
format	article
author	Tamar Abzhandadze Dongni Buvarp Åsa Lundgren-Nilsson Katharina S. Sunnerhagen
author_facet	Tamar Abzhandadze Dongni Buvarp Åsa Lundgren-Nilsson Katharina S. Sunnerhagen
author_sort	Tamar Abzhandadze
title	Barriers to cognitive screening in acute stroke units
title_short	Barriers to cognitive screening in acute stroke units
title_full	Barriers to cognitive screening in acute stroke units
title_fullStr	Barriers to cognitive screening in acute stroke units
title_full_unstemmed	Barriers to cognitive screening in acute stroke units
title_sort	barriers to cognitive screening in acute stroke units
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/cf7f165ea6ef40e7952a57e782d01c98
work_keys_str_mv	AT tamarabzhandadze barrierstocognitivescreeninginacutestrokeunits AT dongnibuvarp barrierstocognitivescreeninginacutestrokeunits AT asalundgrennilsson barrierstocognitivescreeninginacutestrokeunits AT katharinassunnerhagen barrierstocognitivescreeninginacutestrokeunits
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Barriers to cognitive screening in acute stroke units

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