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Journal of Neurology and Neurorehabilitation Research | Volume 4

November 04-05, 2019 | Melbourne, Australia

Neurology and Neurological Disorders

19

th

International Conference on

J Neurol Neurorehabil Res, Volume 4

Comparison of brief clinical delirium and cognitive testing amongst patients admitted

via the Trauma and Orthopaedic (T&O) acute intake - A service evaluation on the

clinical dependence, efficacy and accessibility of implementing Gwent Orientation

and Awareness Listing (GOAL) testing in relation to the 4AT at the Royal Gwent

Hospital Newport, UK

Jack Wellington LGMS

Cardiff University School of Medicine, UK

Background:

GOAL is the brief delirium/cognitive clinical test

currently employed at Royal Gwent Hospital Newport where

the 4AT test is routinely utilized. To our knowledge, both tests

have not been prospectively compared against, relative to

equal patient cohorts.

Objectives:

We aim to, (1) evaluate two rapidly performed

valid cognitive examinations amongst the same patient

cohort, and (2) assess patient testing results among acute/

emergency T&O admissions compared with previously

obtained patient data presenting via the acutemedical intake.

Methods:

Verbal consent to cognitive testing by means of

GOAL and 4AT was sought from patients presenting acutely

to T&O over four weeks period. A GOAL score of <8/10 is

deemed a “fail”, and on 4AT any error is deemed “possible

cognitive impairment”. Patient documentation regarding

dementia, epilepsy, psychiatric/neurological illness was

recorded alongside living arrangements.

Results:

There were 146 patients, of whom 10 were not well

enough to be scored, and 1 patient declined to participate.

Therefore, results are based on a 135-patient cohort, all of

whom were able to co-operate with both scores. Of these,

92 “passed” both tests, 40 “failed” on 4AT, of which 18 also

“failed” on GOAL. There were 3 who “failed” on GOAL but

passed on 4AT. Likelihood of test failure was significantly

greater with 4AT (Х2 =7.65, p<0.01). Ages and comparisons

on GOAL testing results with historical general medical

patient cohort displayed significant differences between

patient co-operation in acute medical and T&O intakes.

Conclusions:

(1) The 4AT test is more likely to signal cognitive

impairment than GOAL among T&O emergency admissions;

(2) T&O intake patients are more likely to co-operate with

cognitive testing by GOAL, and they perform better than

acute medical emergency admissions.

Speaker Biography

Jack Wellington LGMS is a year 4 Medical Student at Cardiff University

Medical School, eager to pursue a career in Neurosurgery alongside

attaining a DTM&H for clinical practice globally, achieve a PhD in Surgical

Sciences (specializing in Neuro infectious Diseases), a WHO Internship

in Geneva, and an academic foundation post (conducting research in

neurosurgical practice). I am currently intercalating at the LSHTM for

an MSc Medical Microbiology and aspire to undertake a neurosurgery

elective at Oxford/Harvard/Yale University. He currently holds various

national and university society positions, examples including Research and

Audit Lead for the Student Psychiatry Audit and Research Collaborative

(SPARC) UK, President and Founder of Cardiff University Infectious

Diseases Society, RCPSG Trainees’ Committee Undergraduate/Student

Member, previous positions including president, clinical and intensive

care leads for Cardiff University Dermatology, Clinical Neurosciences

and Anesthetics, Perioperative and Intensive Care Societies respectively,

and has lead several local and national audits/research projects.

e:

wellingtonj1@cardiff.ac.uk