Development and Validation of an Abbreviated Questionnaire to Easily Measure Cognitive Failure in ICU Survivors: A Multicenter Study

Objectives: To develop and validate an abbreviated version of the Cognitive Failure Questionnaire that can be used by patients as part of self-assessment to measure functional cognitive outcome in ICU survivors. Design: A retrospective multicenter observational study. Setting: The ICUs of two Dutch university hospitals. Patients: Adult ICU survivors. Interventions: None. Measurements and Main Results: Cognitive functioning was evaluated between 12 and 24 months after ICU discharge using the full 25-item Cognitive Failure Questionnaire (CFQ-25). Incomplete CFQ-25 questionnaires were excluded from analysis. Forward selection in a linear regression model was used in hospital A to assess which of the CFQ-25 items should be included to prevent a significant loss of correlation between an abbreviated and the full CFQ-25. Subsequently, the performance of an abbreviated Cognitive Failure Questionnaire was determined in hospital B using Pearson's correlation. A Bland-Altman plot was used to examine whether the reduced-item outcome scores of an abbreviated Cognitive Failure Questionnaire were a replacement for the full CFQ-25 outcome scores. Among 1,934 ICU survivors, 1,737 were included, 819 in hospital A, 918 in hospital B. The Pearson's correlation between the abbreviated 14-item Cognitive Failure Questionnaire (CFQ-14) and the CFQ-25 was 0.99. The mean of the difference scores was –0.26, and 95% of the difference scores fell within +5 and –5.5 on a 100-point maximum score. Conclusions: It is feasible to use the abbreviated CFQ-14 to measure self-reported cognitive failure in ICU survivors as this questionnaire has a similar performance as the full CFQ-25. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://ift.tt/29S62lw). This work was performed at Radboud university medical center and University Medical Centre Utrecht. Drs. Wassenaar, de Reus, Donders, Schoonhoven, Pickkers, and van den Boogaard contributed in study concept and design. Drs. Cremer, van Dijk, de Lange, Slooter, and van den Boogaard contributed in acquisition of data. Drs. Wassenaar, de Reus, and Donders contributed in statistical analysis. Drs. Wassenaar, de Reus, and van den Boogaard contributed in analysis and interpretation of data. Drs. Wassenaar and de Reus contributed in drafting of the article. Drs. Donders, Schoonhoven, Cremer, de Lange, van Dijk, Slooter, Pickkers, and van den Boogaard contributed in critical revision of the article for important intellectual content. Drs. Pickkers and van den Boogaard contributed in study supervision. Dr. Schoonhoven contributed to study cosupervision. The authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: Mark.vandenBoogaard@radboudumc.nl Copyright © by 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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