Abstract 19461: Longitudinal Examination of Neuropsychological and Functional Cognition Outcomes in Patients Following Therapeutic Hypothermia After Cardiac Arrest
Introduction: Therapeutic hypothermia after cardiac arrest has been shown to increase survival to discharge and neurologic recovery. However, neurologic recovery is usually measured by Cerebral Performance Category (CPC) scores that do not discriminate well at the high end of neurological function. Thus, there are significant gaps in knowledge, underlying an important aspect of care related to the assessment and management of education of patients and families about what to expect during the vulnerable transition period from discharge to home and recovery once at home (e.g., return to work, driving).
Methods: This longitudinal, descriptive cohort study examined neurological (cognitive function, language, attention) and functional cognition before hospital discharge and at the 3-6 weeks post-discharge follow up clinic appointment in patients undergoing therapeutic hypothermia after cardiac arrest.
Results: Of the 13 patients who participated, mean age was 59 years with 77% being male; 77% married or in a marriage-like relationship and 46% working full- or part-time. Prior to discharge the sample showed impaired performance on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Attention Index (4th percentile) and a phonemic fluency test (5th percentile), as well as mild memory inefficiency (RBANS Memory Indices = 14th percentile). Improvement was seen in all cognitive domains at 3-6 week follow-up, with phonemic fluency remaining the only score below average (14th percentile). Of the five patients who completed the functional cognition test (Executive Function Performance Test – medication administration where lower scores are better), mean scores were 4 (range 0-9) and 0 (range 0-1), baseline and follow–up, respectively.
Conclusions: Prior to discharge, clinically significant cognitive deficits were evident, with attention and executive functioning deficits being prominent, but cognition was normal at follow up. Functional cognitive testing revealed that during hospitalization most of the patients required at least verbal guidance with some dimension of simple medication management tasks, but most were independent by 3-6 week follow-up.
Author Disclosures: K. Wilson: None. K. Harvison: None. M. Radomski: None. R. Garberich: None. S. Sendelbach: None.
- © 2016 by American Heart Association, Inc.