title: Cognitive outcomes of patients undergoing therapeutic hypothermia after cardiac arrest.
abstract: 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 = 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.
authors.affiliation: Department of Neurology, Internal Medicine, and Anesthesiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Fugate
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Moore
authors.forename: David S
authors.initials: DS
authors.lastname: Knopman
authors.forename: Daniel O
authors.initials: DO
authors.lastname: Claassen
authors.forename: Eelco F M
authors.initials: EF
authors.lastname: Wijdicks
authors.forename: Roger D
authors.initials: RD
authors.lastname: White
authors.forename: Alejandro A
authors.initials: AA
authors.lastname: Rabinstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000473:pathology; D003071:Cognition / Q000502:physiology*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult