title: Measuring outcome after cardiac arrest: construct validity of Cerebral Performance Category.
abstract: BACKGROUND
  Approximately half of the survivors of cardiac arrest have cognitive impairments due to hypoxic brain injury. To describe the outcome after a cardiac arrest, the Cerebral Performance Category (CPC) is frequently used. Although widely used, its validity is still debatable.
  
  
  OBJECTIVE
  To investigate the construct validity of the Cerebral Performance Category in survivors of a cardiac arrest. Participants were 18 years and older that survived a cardiac arrest more than six months.
  
  
  METHODS
  Cross-sectional design. A method to administer the CPC in a structured and reproducible manner was developed. This 'Structured CPC' was administered by a structured interview. Construct variables were Cognitive Failure Questionnaire (CFQ), Barthel Index (BI), Frenchay Activity Index (FAI), Community Integration Questionnaire (CIQ) and Quality of Life after Brain Injury (Qolibri). Associations were tested based on Spearman correlation coefficients.
  
  
  RESULTS
  A total of 62 participants responded. In 58 (94%) patients the CPC was determined, resulting in CPC 1 (48%), CPC 2 (23%) and CPC 3 (23%). The CPC-scoring correlated significantly with the CFQ (r=-0.40); BI (r=-0.57); FAI (r=-0.65), CIQ (r=-0.53) and Qolibri (r=-0.67).
  
  
  CONCLUSIONS
  In this study we developed the 'Structured CPC' to improve the transparency and reproducibility of the original CPC. A moderate correlation between the 'Structured CPC' and the constructs 'activities', 'participation' and 'quality of life' confirmed the validity of the 'Structured CPC'.
  The 'Structured CPC' can be used as an instrument to measure the level of functioning after cardiac arrest.
authors.affiliation: Adelante, Centre of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC Hoensbroek, The Netherlands; Revant Rehabilitation Centre Breda, Brabantlaan 1, 4817 JW Breda, The Netherlands. Electronic address: m.mak@revant.nl.
authors.forename: M
authors.initials: M
authors.lastname: Mak
authors.affiliation: Adelante, Centre of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC Hoensbroek, The Netherlands; CAPHRI School for Public Health and Primary Care, Department of Rehabilitation Medicine, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: V R M
authors.initials: VR
authors.lastname: Moulaert
authors.affiliation: CAPHRI School for Public Health and Primary Care, Department of Cardiology, Maastricht University Medical Centre, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: R W
authors.initials: RW
authors.lastname: Pijls
authors.affiliation: Adelante, Centre of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC Hoensbroek, The Netherlands; CAPHRI School for Public Health and Primary Care, Department of Rehabilitation Medicine, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Verbunt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006323:Heart Arrest / Q000503:physiopathology*; D006801:Humans; D002534:Hypoxia, Brain / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D017741:Survivors
keywords: Cardiac arrest; Cerebral Performance Category; Construct validity; International classification of functioning, disability and health; Outcome; Quality of life