title: Long-term neuropsychological outcomes in children and adolescents after cardiac arrest.
abstract: OBJECTIVE
  Research into neuropsychological functioning of survivors of cardiac arrest (CA) in childhood is scarce. We sought to assess long-term neuropsychological functioning in children and adolescents surviving CA.
  
  
  METHODS
  Neuropsychological follow-up study involving all consecutive children surviving CA between January 2002 and December 2011. Intelligence (IQ), language, attention, memory, visual-spatial, and executive functioning were assessed with internationally validated, neuropsychological tests and questionnaires. Scores were compared with Dutch normative data.
  
  
  RESULTS
  Of 107 eligible children, 47 who visited the outpatient clinic (median follow-up interval: 5.6 years) were analyzed. Fifty-five percent had an in-hospital CA, 86% a non-shockable rhythm, and 49% a respiratory-related etiology. CA survivors scored significantly worse on full-scale IQ (mean = 87.3), verbal IQ (mean = 92.7), performance IQ (mean = 85.6), verbal comprehension index (mean = 93.4), perceptual organization index (mean = 83.8), and processing speed index (mean = 91.1), than the norm population (mean IQ = 100). On neuropsychological tests, compared with norms, respectively adjusted for IQ, significantly worse scores were found on visual memory, significantly better on verbal memory (recognition), and comparable outcomes on visual-motor integration, attention, other measures of verbal memory, and executive functioning. On questionnaires, parents reported better executive functioning than the norm, but teachers reported more problems in planning/organizing skills.
  
  
  CONCLUSIONS
  Long-term neuropsychological assessment of CA survivors showed significant weaknesses, but also relatively intact functioning. As deficits in IQ, memory and executive functioning have significant impact on the child, long-term follow-up and neuropsychological support of CA survivors is warranted.
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.
authors.forename: Lennart
authors.initials: L
authors.lastname: van Zellem
authors.forename: Corinne
authors.initials: C
authors.lastname: Buysse
authors.forename: Marlous
authors.initials: M
authors.lastname: Madderom
authors.forename: Jeroen S
authors.initials: JS
authors.lastname: Legerstee
authors.forename: Femke
authors.initials: F
authors.lastname: Aarsen
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: Elisabeth M
authors.initials: EM
authors.lastname: Utens
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology; D056344:Executive Function / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006323:Heart Arrest / Q000209:etiology / Q000523:psychology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007360:Intelligence / Q000502:physiology; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis*; D009483:Neuropsychological Tests; D011602:Psychophysiologic Disorders / Q000175:diagnosis*; D017741:Survivors; D013997:Time Factors