Cardiac arrest: long-term cognitive and imaging analysis.
BACKGROUND
Neurological and cognitive sequelae resulting from cardiac arrest (CA), despite their potential personal and social impact, are usually not considered as major outcome measures in long-term analysis of survivors. The aim of this study is to analyze the contribution of neuropsychological testing and cerebral imaging to the development of a long-term classification of neurological impairment.


METHODS
A total of 19 patients admitted over a 3 years period in an eight-bed intensive care unit of a tertiary care hospital with a diagnosis of CA were alive and attended a 6-month follow-up consultation. Eleven of these patients agreed to participate in this study carried out between 1 and 3 years after CA. Patients were classified using the Cerebral Performance Categories (CPC), neurological examination, detailed cognitive testing and computerized tomography (CT) scan with qualitative and quantitative imaging analysis.


RESULTS
Six of the 11 patients had good cerebral performance. Verbal and visuo-spatial short-term memory scores were associated with CPC. All patients with at least moderate cerebral disability had abnormal verbal memory test results compared with only one survivor with CPC 1; visuo-spatial short-term memory was abnormal in four moderately affected survivors and normal in those with CPC 1. The bicaudate ratio evaluated in the CT scan was correlated with the verbal memory score while the III ventricle diameter correlated with the executive functions score, suggesting involvement of different brain areas in these functions.


CONCLUSIONS
Neuropsychological and CT scan measurements are proxy measures of long-term impairment of CA survivors, providing a dichotomized global evaluation of CA survivors in close agreement with CPC.
Nunes
Belina
B
Department of Neurology, Hospital Pedro Hispano, 4450 Matosinhos, Portugal. bnunes@weblink.pt
Pais
Joana
J
Garcia
Rute
R
Magalhães
Zita
Z
Granja
Cristina
C
Silva
M Carolina
MC
D000328:Adult; D017677:Age Distribution; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000379:methods*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000150:complications* / Q000628:therapy; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D015588:Observer Variation; D011174:Portugal / Q000453:epidemiology; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D017741:Survivors; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods