• Resuscitation · Jul 2024

    Prospective Evaluation of the Relationship Between Cognition and Recovery Outcomes After Cardiac Arrest.

    • Blennow NordströmErikEColumbia University Irving Medical Center, Department of Neurology, New York, NY, United States; Lund University, Department of Clinical Sciences Lund, Neurology, Lund, Sweden; Skane University Hospital, Department of Rehabilitation , Jeffrey L Birk, Danielle A Rojas, Tara St Onge Sheehy, Camila I Domínguez-Imbert Nieto, Gaspar J Cruz, Maia Ten Brink, William Vargas, Maria Karas, and Sachin Agarwal.
    • Columbia University Irving Medical Center, Department of Neurology, New York, NY, United States; Lund University, Department of Clinical Sciences Lund, Neurology, Lund, Sweden; Skane University Hospital, Department of Rehabilitation Medicine, Lund, Sweden.
    • Resuscitation. 2024 Jul 31; 202: 110343110343.

    PurposeCognitive function is often impaired for cardiac arrest (CA) survivors due to hypoxic-ischemic brain injury. Whether cognitive impairment at hospital discharge is associated with recovery defined as functional status and fatigue measured at 1-month post-discharge is not known.MethodsConsecutive CA patients admitted at an academic center (May 14, 2021-June 23, 2023) were assessed for cognitive impairment (modified Telephone Interview for Cognitive Status, TICS-m < 33) and depressive symptoms (8-item Patient Health Questionnaire) at hospital discharge. Poor functional status (primary outcome; modified Rankin Scale, mRS > 3) and fatigue severity (patient-reported outcome; Modified Fatigue Impact Scale) were assessed 1-month post-discharge. Hierarchical regressions tested associations of cognitive function with outcomes.ResultsOf 112 participants (mean age 54.4 ± 14.8; 38% female; 43% White race, 20% Black race, 29% Hispanic ethnicity) completing discharge TICS-m, 63 (56%) had indicated cognitive impairment, and 68 (61%) had poor 1-month functional outcome. Worse discharge cognitive function was independently associated with a higher risk of poor 1-month functional outcome (OR = 0.88, 95% CI [0.79, 0.98], p = 0.02) after adjusting for age, education, sex, race, ethnicity, length of hospital stay, comorbidities, and depressive symptoms. Fatigue severity lacked significant associations with cognitive function, but was associated with depressive symptoms (B = 1.03 [0.00, 2.05], p = 0.04).ConclusionCognitive function at discharge after CA was significantly and independently associated with functional outcome 1 month after hospital discharge. Psychological distress contributed to fatigue severity. This highlights the need for screening and addressing cognitive and emotional problems pre-hospital discharge.Copyright © 2024 Elsevier B.V. All rights reserved.

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