TY - JOUR
T1 - Cognitive outcomes of patients undergoing therapeutic hypothermia after cardiac arrest
AU - Fugate, Jennifer E.
AU - Moore, Samuel A.
AU - Knopman, David S.
AU - Claassen, Daniel O.
AU - Wijdicks, Eelco F.M.
AU - White, Roger D.
AU - Rabinstein, Alejandro A.
PY - 2013/7/2
Y1 - 2013/7/2
N2 - 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.
AB - 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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U2 - 10.1212/WNL.0b013e318297ee7e
DO - 10.1212/WNL.0b013e318297ee7e
M3 - Article
C2 - 23685933
AN - SCOPUS:84881259082
SN - 0028-3878
VL - 81
SP - 40
EP - 45
JO - Neurology
JF - Neurology
IS - 1
ER -