title: Determinants of cognitive outcome in survivors of out-of-hospital cardiac arrest.
abstract: OBJECTIVE
  To describe cognitive functioning with neuropsychological tests and examine predictors of cognitive outcome in adult survivors of out-of-hospital cardiac arrest (OHCA) of cardiac cause.
  
  
  METHODS
  The study was prospective and took place at the University hospital of North-Norway. Only patients eligible of neuropsychological assessment three months after OHCA were asked to participate. Cognitive test performance was compared to large samples of age-corrected normative data. General linear models were used to determine predictors of a cognitive composite score and performance on separate cognitive tests. The predictors assessed were coma duration, hypothermia treatment and time to restoration of spontaneous circulation. We aimed to control for demographic variables, medical comorbidity and affective symptoms.
  
  
  RESULTS
  45 survivors (4 women) completed the assessment. Neuropsychological tests of fine motor functioning, memory, attention and executive functions were significantly below normative means. Depending on the test, impairment ranged from 9 to 31%. For twenty-five survivors (56%), all cognitive tests were within the normal range. Shorter coma duration and induced hypothermia treatment were associated with favourable cognitive outcomes and explained 45% of the variability in the cognitive composite score. Coma duration was predictive across all cognitive tests, hypothermia treatment of specific tests of memory, attention and executive functioning.
  
  
  CONCLUSIONS
  Cognitive outcome was normal in more than half of the survivors. Shorter coma duration and induced hypothermia were associated with favourable cognitive outcomes in the participating survivors three months after OHCA. Institutional protocol number: 2009/1395.
authors.affiliation: Department of Rehabilitation, Division of Rehabilitation Services, University Hospital of North Norway, Tromsø, Norway. Electronic address: Marte.Orbo@unn.no.
authors.forename: Marte
authors.initials: M
authors.lastname: Ørbo
authors.affiliation: Department of Psychology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway; Department of Child and Adolescent Psychiatry, Division of Child and Adolescent Health, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Per M
authors.initials: PM
authors.lastname: Aslaksen
authors.affiliation: Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Kristina
authors.initials: K
authors.lastname: Larsby
authors.affiliation: Department of Rehabilitation, Division of Rehabilitation Services, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Lena
authors.initials: L
authors.lastname: Norli
authors.affiliation: Department of Rehabilitation, Division of Rehabilitation Services, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schäfer
authors.affiliation: Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Pål M
authors.initials: PM
authors.lastname: Tande
authors.affiliation: Department of Radiology, Division of Diagnostic Services, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.
authors.forename: Torgil R
authors.initials: TR
authors.lastname: Vangberg
authors.affiliation: Department of Rehabilitation, Division of Rehabilitation Services, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.
authors.forename: Audny
authors.initials: A
authors.lastname: Anke
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000401:mortality*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006785:Hospitals, University; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods / Q000401:mortality*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009664:Norway; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy*; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D013997:Time Factors; D055815:Young Adult
keywords: Cardiac arrest; Cognitive impairments; Hypothermia; Neuropsychological tests; Resuscitation