Cognitive dysfunction and health‐related quality of life after a cardiac arrest and therapeutic hypothermia

Torgersen, Johan; Strand, Kristian; Bjelland, Thor Wilhelm; Klepstad, Pål; Kvåle, Reidar; Søreide, Eldar; Wentzel‐Larsen, Tore; Flaatten, Hans

doi:10.1111/j.1399-6576.2010.02219.x

Cited by 78 publications

(60 citation statements)

References 41 publications

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“…Indeed, other authors have also been unable to demonstrate an association with QoL in survivors of cardiac arrest. 21,22 It is likely that for highly functioning individuals, other factors are more influential in QoL perceptions. Therefore, in practice, documenting neurological parameters alone may not be sufficient to assess patient wellbeing; reporting outcomes beyond cognitive function should be considered.…”

Section: Discussionmentioning

confidence: 99%

Psychological wellbeing in survivors of cardiac arrest, and its relationship to neurocognitive function

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Psychological wellbeing in survivors of cardiac arrest, and its relationship to neurocognitive function

et al. 2017

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“…[6][7][8] Despite a good outcome according to the CPC, cognitive difficulties may be prevalent as reported in several smaller studies using neuropsychological tests. 9,10 In a recent review, 30% to 50% of survivors after cardiac arrest were reported to suffer from cognitive impairment. 11 The generalizability of previous studies is poor because of small sample sizes, [12][13][14] missing data, 13,14 and patient selection, that is, the exclusion of those with a poor outcome, 14 inclusion of only patients with severe symptoms, 12 or absence of a nonarrest control group.…”

Section: Clinical Perspective On P 1349mentioning

confidence: 99%

Cognitive Function in Survivors of Out-of-Hospital Cardiac Arrest After Target Temperature Management at 33°C Versus 36°C

et al. 2015

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Background— Target temperature management is recommended as a neuroprotective strategy after out-of-hospital cardiac arrest. Potential effects of different target temperatures on cognitive impairment commonly described in survivors have not been investigated sufficiently. The primary aim of this study was to evaluate whether a target temperature of 33°C compared with 36°C was favorable for cognitive function; the secondary aim was to describe cognitive impairment in cardiac arrest survivors in general. Methods and Results— Study sites included 652 cardiac arrest survivors originally randomized and stratified for site to temperature control at 33°C or 36°C within the Target Temperature Management trial. Survival until 180 days after the arrest was 52% (33°C, n=178/328; 36°C, n=164/324). Survivors were invited to a face-to-face follow-up, and 287 cardiac arrest survivors (33°C, n=148/36°C, n=139) were assessed with tests for memory (Rivermead Behavioural Memory Test), executive functions (Frontal Assessment Battery), and attention/mental speed (Symbol Digit Modalities Test). A control group of 119 matched patients hospitalized for acute ST-segment–elevation myocardial infarction without cardiac arrest performed the same assessments. Half of the cardiac arrest survivors had cognitive impairment, which was mostly mild. Cognitive outcome did not differ ( P >0.30) between the 2 temperature groups (33°C/36°C). Compared with control subjects with ST-segment–elevation myocardial infarction, attention/mental speed was more affected among cardiac arrest patients, but results for memory and executive functioning were similar. Conclusions— Cognitive function was comparable in survivors of out-of-hospital cardiac arrest when a temperature of 33°C and 36°C was targeted. Cognitive impairment detected in cardiac arrest survivors was also common in matched control subjects with ST-segment–elevation myocardial infarction not having had a cardiac arrest. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01946932.

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“…23 Another study included 26 patients who had been treated with TH, only evaluating those with a CPC score of 1 or 2, and found that 52% had cognitive dysfunction. 24 Three prospective studies of patients who were not treated with TH found cognitive dysfunction in 42% to 50% of survivors. 12,14,15 Our study cannot define the impact of TH on cognitive outcomes, but it shows that the majority of survivors regain good cognitive function.…”

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confidence: 99%

“…22 Two small series found that a larger proportion (approximately 50%) of TH-treated cardiac arrest survivors had cognitive impairment. 23,24 One study of 43 patients found that 48% had cognitive impairment, half of whom had "mild" deficits. 23 The Neurobehavioral Cognitive Status Examination (Cognistat) was used for the cognitive screening test.…”

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confidence: 99%

“…Most studies have similarly found that the most common cognitive domains affected after survival of cardiac arrest are memory and executive function. 12,13,15,22,24 In a systematic review (largely of patients not treated with TH), memory problems, followed by attention and executive dysfunction, were frequently encountered. 16 Clinicians who care for patients surviving OHCA should be aware of the possibility of cognitive deficits, even when neurologic outcome appears favorable in the acute phase.…”

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confidence: 99%

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Cognitive outcomes of patients undergoing therapeutic hypothermia after cardiac arrest

et al. 2013

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Objective: We aimed to study the long-term cognitive abilities of patients surviving out-of-hospital cardiac arrest who were treated with therapeutic hypothermia (TH). Methods:We prospectively identified and examined consecutive survivors of out-of-hospital cardiac arrest who underwent TH at our institution from June 2006 to May 2011. The results of brain imaging, serum neuron-specific enolase (NSE) measurements, and EEGs were recorded. We assessed cognitive domains using the modified Telephone Interview for Cognitive Status. An education-adjusted score of $32 was considered normal.Results: Of 133 total patients, 77 (58%) were alive at a median follow-up of 20 months (interquartile range 14-24 months). We interviewed 56 patients (73% of those alive). Median age was 67 years (range 24-88 years). Fifty-one patients (91%) were living independently. Modified Telephone Interview for Cognitive Status scores ranged from 16 to 41. Thirty-three (60%) were considered cognitively normal and 22 (40%) were cognitively impaired. The time to assessment did not differ among the cognitive outcomes (p 5 0.557). The median duration of coma was 2 days, possibly indicating that patients with severe anoxic injury were not included. Eighteen patients were not working at the time of their cardiac arrest (17 were retired and 1 was unemployed). Of the 38 patients who were working up to the time of the cardiac arrest, 30 (79%) returned to work. Cognitive outcome was not associated with age, time to return of spontaneous circulation, brain atrophy, or leukoaraiosis. Conclusions:The majority of surviving patients who underwent TH after cardiac arrest in this series had preserved cognitive function and were able to return to work.

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Cognitive dysfunction and health‐related quality of life after a cardiac arrest and therapeutic hypothermia

Abstract: Half of the patients had a cognitive dysfunction with reduced performance on executive function and episodic memory, indicating frontal and temporal lobe affection, respectively. Reduced performance did not affect HRQOL.

Cited by 78 publications

References 41 publications

Psychological wellbeing in survivors of cardiac arrest, and its relationship to neurocognitive function

Psychological wellbeing in survivors of cardiac arrest, and its relationship to neurocognitive function

Cognitive Function in Survivors of Out-of-Hospital Cardiac Arrest After Target Temperature Management at 33°C Versus 36°C

Cognitive outcomes of patients undergoing therapeutic hypothermia after cardiac arrest

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