Abstract 10843: The Effect of Therapeutic Hypothermia on Neurocognitive Function in Long-term Survivors of Cardiac Arrest
Background: The advent of therapeutic hypothermia (TH) has led to increased post-cardiac arrest survival, yet often with variable neurologic recovery. Few studies have quantitatively evaluated TH-treated arrest survivors for long-term neurocognitive deficits.
Objective: Using a validated computer-based neurocognitive battery in a cohort of arrest survivors, we hypothesized that survivors who underwent TH would exhibit better neurocognitive performance than those who had not undergone TH.
Methods: Arrest survivors discharged from one tertiary hospital between 1/2009-12/2010 who returned home were eligible for inclusion. The Web-based Computerized Neuropsychological Battery (WebCNP) was administered in the home of each subject, evaluating performance in 11 cognitive domains with regard to response time and accuracy. Performances were compared to a validated healthy subject cohort with normal distribution; statistical evaluation was performed using z scores.
Results: Of 36 arrest survivors who were randomly contacted, 20/36 (55%) completed the study. Mean time from arrest to testing was 1.2±0.7 yrs. Mean age was 54±16 yrs; 7/20 (35%) were female. Initial rhythm was VF/VT in 16/20 (80%); 8/20 (40%) underwent TH. All subjects were alert, communicative and living independently at home. Mean duration of the neurocognitive evaluation per subject was 79±15 min. Post-arrest subjects had slower response times than healthy controls on 14/15 tests; 4 of these differences were statistically significant (p <0.05). Subjects scored lower than controls on 13/13 accuracy tests with one of these being statistically significant (p<0.05). Subjects receiving TH performed better on 12/15 response time tests than non-TH treated subjects; TH subjects performed more accurately on 9/13 tests than non-TH treated subjects; one of these was statistically significant (p=0.03).
Conclusion: Arrest survivors exhibited deficits in specific domains of cognitive function compared to a validated healthy cohort. Non-TH subjects demonstrated slower response times and lower accuracy scores than TH-treated counterparts. These results demonstrate the potential value of quantitative evaluation of neurocognitive outcome for future post-arrest clinical studies.
- © 2011 by American Heart Association, Inc.