Abstract 156: Neurocognitive Recovery Improves After Discharge for Therapeutic Hypothermia Patients
OBJECTIVE: Therapeutic Hypothermia (TH) treatment for resuscitated cardiac arrests has been shown to be effective in reducing anoxic encephalopathy among survivors of out of hospital cardiac arrest. Many patients are discharged with some degree of neurocognitive dysfunction. Our aim was to see whether or not their level of cerebral function improved after discharge at a six month follow up interval.
METHODS: We performed 6 month follow-up on 279 consecutive patients, whom underwent TH after cardiac arrest (deemed to be from a cardiac origin) from 4/30/2006 to 12/31/2012. Cerebral function after TH was measured by the five point Cerebral Performance (CPC) scale at discharge and at six months. CPC scores of 1 and 2 are considered positive neurologic outcomes, 3 and 4 are negative neurologic outcomes, and 5 is death. RESULTS: Of the 279 patients who underwent TH, 146 (52.3%) survived to hospital discharge. Discharge CPC scores were 1 (56%), 2 (32%), 3 (8%), 4 (3%). Of the 146 patients that were discharged, 10 (7%) died including 7 with CPC of 3 or 4. Six month CPC scores are shown in Table 1. At six months, 53% of those patients with a CPC score of 2 at discharge improved to a CPC score of 1 and 17% of patients with a CPC scan improved to a score of 2 and 17% improved to a score of 1.
CONCLUSION: Significant improvements in CPC score commonly occur by six months for those patients with a discharge CPC score of 2, while neurocognitive recovery occurs in only a third of patients with CPC 3. Neurocognitive recovery at six months is limited in most patients with a discharge CPC of 3 or 4, and death rates are high. In contrast, the majority of patients had a discharge CPC score of 1 or 2, had low 6-month mortality and excellent neurologic recovery.
- © 2012 by American Heart Association, Inc.