Brigham and Women’s Hospital Starts Preoperative Cognitive Screening

A quick screening test, used on all patients 65 years and older, helps identify those at risk for postoperative delirium. But don’t mistake it for a diagnostic test for dementia.

April 12, 2019
by Sandra Gordon for ASA

Brigham and Women’s Hospital, which is affiliated with Harvard Medical School, recently began implementing preoperative cognitive screening for all surgical patients 65 years and older. The new protocol is the result of research published in Anesthesiology in November 2017, which screened 211 patients 65 years and older without a diagnosis of dementia who were scheduled for an elective hip or knee replacement.

Using the Mini-Cog, a two-minute screening test that requires patients to remember a few words and draw a clock with the hands set to a specific time, the study found that 24 percent of patients screened positive for probable cognitive impairment.

“The Mini-Cog is a way to identify patients who is at higher risk for postoperative delirium,” says Gregory Crosby, M.D., anesthesiologist at Brigham and Women’s Hospital in the department of perioperative and pain medicine and associate professor of anesthesia at Harvard Medical School, who was one of the study’s researchers.

At Brigham and Women’s Hospital, the results of a patient’s Mini-Cog are noted in the patient’s chart. Ideally, a geriatrician then gets involved in the patient’s care in a preop clinic. The hospital is in the development stage of implementing next steps. More research needs to be done to determine the implications for patient care, Dr. Crosby says.

We Want to Hear from You

Did you work to improve the perioperative experience for patients at risk for delirium? Share your story by entering a few brief details into our SBAR template below. We’ll contact you for more information.

# # #

ASA and the PBHI does not endorse specific hospital procedures, policies or programs outlined in this content. All research and clinical material published in this article (above) by ASA and the PBHI is for informational purposes only. Readers are encouraged to confirm the information contained herein with other sources and consider applications within the context of their local environment. Patients and consumers should review the information carefully with their professional health care provider. The information is not intended to replace medical advice offered by physicians. ASA and PBHI will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising therefrom.

Back to News