Cognitive function and quality of life after successful resuscitation from cardiac arrest

Abstract

Background: Studies on out-of-hospital cardiac arrest (OHCA) use overall performance category (OPC)/cerebral performance category (CPC) as outcome. We studied quality of life, neuro-cognitive functioning and independency in daily life of patients and strain of caregivers 6-12 months after cardiac arrest.

Methods: Two hundred and twenty patients (>18 year) who survived 6-12 months after OHCA and relatives were interviewed by telephone with validated questionnaires (Short-form Health Survey) (SF-12), Modified Rankin Scale (MRS), telephonic interview cognitive status (TICS) and Caregiver Strain Index (CSI) and compared with OPC and CPC at discharge. SF-12 of elderly (≥80 years) was compared to an open Dutch population of ≥80 years.

Results: Of all patients, 45% had normal physical and 90% had normal mental SF-12. Eighty-one percent had a normal MRS (MRS≤2). Eighty-four percent had normal TICS. Compared to the reference population, elderly scored 40.5 on the mental physical [corrected] and 53.2 on the physical mental [corrected] SF-12, while the reference population scored 38.1 (θ=0.20) and 54.4 (θ=-0.15), respectively, (n.s.) Of the patients with OPC≤2 and CPC≤2 at discharge 15% scored MRS 3-5 and 15% abnormal TICS at follow-up, respectively. Ninety-two percent of all patients gave their quality of life a value of ≥6 (maximum 10). Patients treated with hypothermia scored on most health outcomes similar to those who did not need such treatment. Sixteen percent of caregivers experienced strain, correlating significantly with TICS of patients.

Conclusion: The great majority of survivors have normal functioning and cognition 6-12 months after OHCA. Functional and neuro-cognitive telephonic tests 6-12 months after OHCA are simple and better reflect patients functioning at home than OPC/CPC at discharge.

Keywords: Cardiopulmonary resuscitation; Cognition; Heart arrest; Outcome; Quality of life.