Cognitive dysfunction and health-related quality of life after a cardiac arrest and therapeutic hypothermia.
BACKGROUND
Evidence-based treatment protocols including therapeutic hypothermia have increased hospital survival to over 50% in unconscious out-of-hospital cardiac arrest survivors. In this study we estimated the incidence of cognitive dysfunctions in a group of cardiac arrest survivors with a high functional outcome treated with therapeutic hypothermia. Secondarily, we assessed the cardiac arrest group's level of cognitive performance in each tested cognitive domain and investigated the relationship between cognitive function and age, time since cardiac arrest and health-related quality of life (HRQOL).


METHODS
We included 26 patients 13-28 months after a cardiac arrest. All patients were scored using the Cerebral Performance Category scale (CPC) and Mini-Mental State Examination (MMSE). Twenty-five of the patients were tested for cognitive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB). These patients were tested using four cognitive tests: Motor Screening Test, Delayed Matching to Sample, Stockings of Cambridge and Paired Associate Learning from CANTAB. All patients filled in the Short Form-36 for the assessment of HRQOL.


RESULTS
Thirteen of 25 (52%) patients were classified as having a cognitive dysfunction. Compared with the reference population, there was no difference in the performance in motor function and delayed memory but there were significant differences in executive function and episodic memory. We found no associations between cognitive function and age, time since cardiac arrest or HRQOL.


CONCLUSIONS
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.
Department of Anaesthesiology and Intensive Care Medicine, Haukeland University Hospital, Bergen, Norway. jgto@helse-bergen.no
J
J
Torgersen
K
K
Strand
T W
TW
Bjelland
P
P
Klepstad
R
R
Kvåle
E
E
Søreide
T
T
Wentzel-Larsen
H
H
Flaatten
D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D056344:Executive Function; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000503:physiopathology; D006323:Heart Arrest / Q000523:psychology* / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects* / Q000523:psychology; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology / Q000523:psychology; D015994:Incidence; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D011788:Quality of Life; D013702:Temporal Lobe / Q000503:physiopathology; D055815:Young Adult