Recovery, long-term cognitive outcome and quality of life following out-of-hospital cardiac arrest.
OBJECTIVE
Among survivors of out-of-hospital cardiac arrest (OHCA), the functional outcomes of those with rapid early or with very delayed recoveries are known. For patients between those extremes early recovery is variable, and the probability of longer-term recovery and the implications for quality of life have not been clearly defined.


METHODS
Twenty-five patients of a consecutive cohort of OHCA survivors with coma duration between 12 h and 7 days and a matched group with acute coronary syndrome underwent cognitive and disability assessments 3 and 12 months after OHCA. Correlations and regression analyses of demographic, clinical arrest variables, and cognitive tests with quality of life outcomes were performed.


RESULTS
The OHCA group had impairments in all cognitive domains. There was little cognitive improvement. The OHCA group reported significantly greater health impact and lower quality of life at twelve months than the controls. Longer duration of coma (4-7 versus ≤ 3 days) and greater cognitive impairment at three months, particularly memory impairment, were both associated with reduced late quality of life.


CONCLUSIONS
These survivors of OHCA had persistent long-term cognitive deficits. Quality of life at one year after OHCA was reduced compared to cardiac controls. Coma duration and memory impairment at three months were harbingers of long term reduced quality of life.
, Cognitive Neurology Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston Massachusetts, USA. clim@bidmc.harvard.edu.
Chun
C
Lim
Mieke
M
Verfaellie
David
D
Schnyer
Ginette
G
Lafleche
Michael P
MP
Alexander
D016022:Case-Control Studies; D003072:Cognition Disorders; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D017741:Survivors / Q000523:psychology*; D013997:Time Factors