• Resuscitation · Dec 2018

    Long-term neurological outcomes in out-of-hospital cardiac arrest patients treated with targeted-temperature management.

    • Juan Caro-Codón, Juan R Rey, Esteban Lopez-de-Sa, Óscar González Fernández, Sandra O Rosillo, Eduardo Armada, Ángel M Iniesta, Jaime Fernández de Bobadilla, José Ruiz Cantador, Laura Rodríguez Sotelo, Francisco Javier Irazusta, Verónica Rial Bastón, Pablo Merás Colunga, and José Luis López-Sendón.
    • Cardiology Department, Hospital Universitario La Paz, Madrid, Spain. Electronic address: juancarocd@gmail.com.
    • Resuscitation. 2018 Dec 1; 133: 33-39.

    BackgroundThis study aimed to assess long-term cognitive and functional outcomes in out-of-hospital cardiac arrest (OHCA) patients treated with targeted-temperature management, investigate the existence of prognostic factors that could be assessed during initial admission and evaluate the usefulness of classic neurological scales in this clinical scenario.MethodsPatients admitted due to OHCA from August 2007 to November 2015 and surviving at least one year were included. Each patient completed a structured interview focused on the collection of clinical, social and demographic data. All available information in clinical records was reviewed and a battery of neurocognitive and psychometric tests was performed.ResultsSeventy-nine patients were finally included in the analysis. Forty-three patients (54.4%) scored below the usual cut-off points for the diagnosis of mild cognitive impairment, even though most of these deficits went unnoticed when patients were assessed using CPC and modified Rankin scale. Nineteen (24%) developed certain degree of impairment in their attention capacity and executive functions. A significant proportion developed new memory-related disorders (43%), depressive symptoms (17.7%), aggressive/uninhibited behavior (12.7%) and emotional lability (8.9%). A greater number of weekly hours of intellectual activity and a qualified job were independent protective factors for the development of cognitive impairment. However, being older at the time of the cardiac arrest was identified as a poor prognostic factor.ConclusionsThere is a high prevalence of long-term cognitive deficits and functional limitations in OHCA survivors. Most commonly used clinical scales in clinical practice are crude and lack sensitivity to detect most of these deficits.Copyright © 2018 Elsevier B.V. All rights reserved.

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