Resilience, Cognitive Reserve And Brain Reserve In Neurocritical Care: A Prospective Cohort Study

Objective: We have designed a prospective, longitudinal cohort study using periodic telephonic follow-up for self-reported or surrogate reported outcomes to understand the impact of resilience and reserve in neurocritical care patients. Background: Neurocritical illness often occurs as a sudden catastrophic event and leaves patients with significant long-term cognitive, behavioral and neurological disturbances . Resilience, cognitive reserve and brain reserve have been shown to influence outcomes in psychiatric and geriatric disorders. The impact of resilience, cognitive reserve and brain reserve on recovery in neurocritical care has not been investigated. Design/Methods: English or Spanish speaking adults admitted to the Neuro-ICU at Mount Sinai Hospital with an expected length of stay of ≥48 hours and one or two surrogates have been included. Demographic, clinical, radiographic and outcomes data are collected for every patient enrolled. Education and occupation as surrogate markers of cognitive reserve, normalized intracranial volume, cortical volumes using a Free surfer pipeline as markers of brain reserve are recorded. To measure resilience, the Connor-Davidson-10 Resilience (CD-RISC 10) is administered to patients who can speak for themselves and to at least one surrogate. Follow-up outcomes data including modified Rankin (mRS), EuroQOL-5D-5L and Telephonic Interview for Cognitive Status (TICS) is collected prior to discharge, at 3 months and at 12 months via telephone. Results: Between April to August,2016 we enrolled 79 patients. Mean age was 57 ± 14; 29% were males. 48/79 patients filled out CD-RISC 10 for themselves, while surrogate responses were collected for 58/79. Common diagnoses included subarachnoid hemorrhage (26) and intracranial hemorrhage (9) and subdural hematomas (8). Follow-up data on 62/79 patients showed a median discharge mRS of 4. Conclusions: In this ongoing cohort study with longitudinal follow-up we will be able to gather powerful data for understanding impact of constructs like resilience and reserve on an individual’s abilities to cope and bounce back from neuroemergencies. Disclosure: Dr. Dangayach has nothing to disclose. Dr. Griffiths has nothing to disclose. Dr. Feng has nothing to disclose. Dr. Keogh has nothing to disclose. Dr. Sharma has nothing to disclose. Dr. Wheelwright has nothing to disclose. Dr. Marin has nothing to disclose. Dr. Sumowski has nothing to disclose. Dr. Costa has nothing to disclose. Dr. Sobotka has nothing to disclose. Dr. Bederson has nothing to disclose. Dr. Mocco has nothing to disclose. Dr. Gordon has nothing to disclose. Dr. Mayer has received personal compensation for activities with Bard Medical.