Feasibility of a web-based neurocognitive battery for assessing cognitive function in critical illness survivors

Abstract

Purpose To assess the feasibility of using a widely validated, web-based neurocognitive test battery (Cambridge Brain Sciences, CBS) in a cohort of critical illness survivors. Methods We conducted a prospective observational study in two intensive care units (ICUs) at two tertiary care hospitals. Twenty non-delirious ICU patients who were mechanically ventilated for a minimum of 24 hours underwent cognitive testing using the CBS battery. The CBS consists of 12 cognitive tests that assess a broad range of cognitive abilities that can be categorized into three cognitive domains: reasoning skills, short-term memory, and verbal processing. Patients underwent cognitive assessment while still in the ICU (n = 13) or shortly after discharge to ward (n = 7). Cognitive impairment on each test was defined as a raw score that was 1.5 or more standard deviations below age- and sex-matched norms from healthy controls. Results We found that all patients were impaired on at least two tests and 18 patients were impaired on at least three tests. ICU patients had poorer performance on all three cognitive domains relative to healthy controls. We identified testing related fatigue due to battery length as a feasibility issue of the CBS test battery. Conclusions Use of a web-based patient-administered cognitive test battery is feasible and can be used in large-scale studies to identify domain-specific cognitive impairment in critical illness survivors and the temporal course of recovery over time.