Perioperative medicine & outcomes
The utility of the Montreal cognitive assessment (MoCA) in detecting cognitive impairment in surgical populations – A systematic review and meta-analysis
Authors' conclusion
MoCA with a cut-off score of <26 was shown to have 87% sensitivity and 72% specificity in identifying CI. A positive screen in MoCA was associated with a 3-day longer hospital LOS in cardiac surgery in the CI group than in the non-CI group.
Study context
- Population
- Adults undergoing elective or emergent surgery screened preoperatively for cognitive impairment (CI) with the MoCA
- Participants
- 5,059 adults · 26 studies
- Comparison
- MoCA vs Petersen criteria, DSM or NIA-AA criteria for CI
- Outcome
- Diagnostic accuracy for CI (cut-off <26)
Pooled result
As reported in the abstract
| Group | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|
| MoCA | 0.87 (95% CI: 0.79-0.93) | 0.72 (95% CI: 0.62-0.80) | 0.74 (95% CI: 0.65-0.81) | 0.86 (95% CI: 0.77-0.92) |
MoCA
Sensitivity0.87 (95% CI: 0.79-0.93)
Specificity0.72 (95% CI: 0.62-0.80)
PPV0.74 (95% CI: 0.65-0.81)
NPV0.86 (95% CI: 0.77-0.92)
Further pooled results
| Outcome | Difference (days) (95% CI) | P value | |
|---|---|---|---|
| Hospital LOS, CI vs non-CI, non-cardiac surgery | 3.75 (−0.03-7.53) | P = 0.05 | |
| Hospital LOS, CI vs non-CI, cardiac surgery | 3.33 (1.24–5.41) | P < 0.002 | |
| −50510Difference, days (linear scale) |
Prevalence of preoperative CI (MoCA <26)
- Pooled prevalence of preoperative CI
- 48% (95% CI: 41%-54%)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
The utility of the Montreal cognitive assessment (MoCA) in detecting cognitive impairment in surgical populations – A systematic review and meta-analysis. J Clin Anesth. Published 20 July 2024. doi:10.
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