• Pauline C W van Gils, Barry J Ruijter, Rubia J K Bloo, van PuttenMichel J A MMJAMClinical Neurophysiology (CNPH), TechMed Centre, University of Twente, Enschede, the Netherlands; Departments of Neurology and Clinical Neurophysiology, Medisch Spectrum Twente, Enschede, the Netherlands., Norbert A Foudraine, Moniek S E van Hout, Selma C Tromp, van MookWalther N K AWNKADepartment of Intensive Care Medicine, and Academy for Postgraduate Training, Maastricht University Medical Centre+, the Netherlands; School of Health Professions Education, Maastricht University, the Netherlands., RouhlRob P WRPWDepartment of Neurology, Maastricht University Medical Centre+, the Netherlands; Academic Centre for Epileptology Kempenhaeghe/MUMC+, the Netherlands., Caroline M van Heugten, Jeannette Hofmeijer, and TELSTAR investigators.
• Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Clinical Neurophysiology (CNPH), TechMed Centre, University of Twente, Enschede, the Netherlands; Limburg Brain Injury Center, Maastricht University, Maastricht, the Netherlands. Electronic address: c.vangils@maastrichtuniversity.nl.
• Resuscitation. 2023 Aug 1; 189: 109830109830.

AimRhythmic and periodic patterns (RPPs) on the electroencephalogram (EEG) in comatose patients after cardiac arrest have been associated with high case fatality rates. A good neurological outcome according to the Cerebral Performance Categories (CPC) has been reported in up to 10% of cases. Data on cognitive, emotional, and quality of life outcomes are lacking. We aimed to provide insight into these outcomes at one-year follow-up.MethodsWe assessed outcome of surviving comatose patients after cardiac arrest with RPPs included in the 'treatment of electroencephalographic status epilepticus after cardiopulmonary resuscitation' (TELSTAR) trial at one-year follow-up, including the CPC for functional neurological outcome, a cognitive assessment, the hospital anxiety and depression scale (HADS) for emotional outcomes, and the 36-item short-form health survey (SF-36) for quality of life. Cognitive impairment was defined as a score of more than 1.5 SD below the mean on ≥ 2 (sub)tests within a cognitive domain.ResultsFourteen patients were included (median age 58 years, 21% female), of whom 13 had a cognitive impairment. Eleven of 14 were impaired in memory, 9/14 in executive functioning, and 7/14 in attention. The median scores on the HADS and SF-36 were all worse than expected. Based on the CPC alone, 8/14 had a good outcome (CPC 1-2).ConclusionNearly all cardiac arrest survivors with RPPs during the comatose state have cognitive impairments at one-year follow-up. The incidence of anxiety and depression symptoms seem relatively high and quality of life relatively poor, despite 'good' outcomes according to the CPC.Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.

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