Long-term neurological outcome after cardiac arrest and therapeutic hypothermia.
OBJECTIVE
To analyse the neurological status of survivors after cardiac arrest (CA) treated with hypothermia.


METHODS
We prospectively included all patients with CA treated with hypothermia at intensive care units (ICU) in two university hospitals and one regional hospital. All adult survivors at 6 months after CA, n=48, were invited for neurological follow-up and 43 accepted. History, clinical status, ability testing and questionnaires were administered to screen for difficulties, including Assessment of Motor and Process Skills, Neurobehavioral Cognitive Status Examination, Frontal Lobe Assessment Battery, EQ-VAS quality of life scale, Skåne Sleep Index, Hospital Anxiety and Depression Rating Scale, Self-reported Montgomery and Astrand Depression Rating Scale, Global Deterioration Scale, Rivermead Behavioural Memory Test, and the Cerebral Performance Categories (CPC).


RESULTS
No patient was found to be in a chronic vegetative state and all patients were living at home, one with extensive help. Thirty-six patients were in CPC1 at follow-up, and some degree of neurological sequelae was found in 40 patients, but was mild in all but 3. Three patients had no subjective complaints, nor could any deficits be detected. Initial defects improved over-time. Short-term memory loss, executive frontal lobe dysfunction along with mild depression and sleep rhythm disturbances were the most common findings.


CONCLUSIONS
Mild cognitive impairment is common following hypothermia-treated cardiac arrest but has little effect on activities of daily living or quality of life.
Cronberg
Tobias
T
Department of Clinical Sciences, Lund - Section for Neurology, Lund University, Sweden. Tobias.Cronberg@skane.se
Lilja
Gisela
G
Rundgren
Malin
M
Friberg
Hans
H
Widner
Håkan
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006323:Heart Arrest / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D055815:Young Adult