Abstract 85: The Overall Performance Category and Cerebral Performance Category to Assess Neurologically Intact Survival at Discharge from Cardiac Arrest: A Good Estimate of Patients’ Functioning?
Objective- It is known that recovery from neurologic damage takes 6-12 months. However, most studies on out of hospital cardiac arrest (OHCA) use the Overall Performance Category (OPC)/Cerebral Performance Category (CPC) as outcome at discharge from hospital. We studied the neurocognitive functioning and level of independence (LoI) of patients (pts) 6-12 months after OHCA and compared the results with the OPC/CPC at discharge.
Materials and methods- The study population comprises all pts (>18 year) who survived 6-12 months after OHCA from mid-2010 to mid-2011. Pts were interviewed by telephone with questionnaires validated for telephonic application. We used a validated cut-off score. Neurocognitive functioning was measured with the Telephonic Interview Cognitive Status (TICS) and LoI with the Modified Rankin Scale (MRS). If needed, the IQ-code was used as proxy-questionnaire to measure the neurocognitive functioning of the pt. Neurological outcome at discharge was assessed from hospital records estimating OPC/CPC (figure).
Results- Comparison between OPC at discharge and MRS at 6-12 months is shown in the figure. Of all pts, 93% was classified as having a good outcome (OPC 1-2) at discharge. At 6-12 months only 76% had a good outcome (MRS 0-2). Thirty of the 218 (13%) pts seemed to be cognitively impaired (TICS <31) at 6-12 months while they were classified as having a good outcome (CPC 1-2) at discharge.
Conclusion- MRS and other tests 6-12 months after discharge better reflect pts’ functioning at home than OPC/CPC at the moment of discharge. OPC/CPC cannot measure impairments that manifest themselves only in the home environment.
- © 2012 by American Heart Association, Inc.