Abstract Details

Title Cognitive Outcomes of Patients Undergoing Therapeutic Hypothermia after Out-of-Hospital Cardiac Arrest

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) S07 - (-)

Poster/Presentation
Number 004

Background Most studies of comatose survivors of cardiac arrest focus on mortality or functional outcome based on physical limitations. We aimed to study the long-term cognitive abilities of patients surviving out-of-hospital cardiac arrest who were treated with therapeutic hypothermia (TH).

Objective

Design/Methods Consecutive survivors of cardiac arrest who underwent TH from June 2006-May 2011 were prospectively identified. We reviewed the medical records and recorded the results of brain imaging, serum neuron-specific enolase (NSE) measurements, and electroencephalograms. We assessed cognitive domains using the Telephone Interview for Cognitive Status (TICS-m). An education-adjusted score ? 32 was considered normal.

Results Of 133 total patients, 77 (58%) were alive at a mean follow-up of 21 months (range 2-59 months). We interviewed 56 patients (73% of those alive). Median age was 67 years (range 24-88 years). Fifty-one patients (91%) were living independently. Median TICS-m score was 33 (range 16-41). Thirty-three (60%) were considered cognitively normal and 22 (40%) were cognitively impaired. The time-to-assessment did not differ among the cognitive outcomes (p=0.557). Eighteen patients were not working at the time of their cardiac arrest (17 were retired and 1 was unemployed). Of the 38 patients who were working up to the time of the cardiac arrest, 30 (79%) returned to work. Cognitive outcome was not associated with age, time to return of spontaneous circulation, brain atrophy, leukoaraiosis, or NSE level.

Conclusions The majority of patients treated with TH after cardiac arrest had preserved cognitive function and were able to return to work.

Authors/Disclosures
Samuel A. Moore, MD PRESENTER	No disclosure on file
Jennifer E. Fugate, DO (Mayo Clinic)	No disclosure on file
David S. Knopman, MD, FAAN (Mayo Clinic)	Dr. Knopman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for DIAN TU study. The institution of Dr. Knopman has received research support from NIH.
Daniel O. Claassen, MD, FAAN (Vanderbilt University Medical Center)	Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Spark . The institution of Dr. Claassen has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Alterity. Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Michigan. Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for HD Insights. The institution of Dr. Claassen has received research support from NIH. The institution of Dr. Claassen has received research support from CHDI. The institution of Dr. Claassen has received research support from HDSA. The institution of Dr. Claassen has received research support from Department of Defense. The institution of Dr. Claassen has received research support from CHDI. The institution of Dr. Claassen has received research support from Genentech/ Roche.
	No disclosure on file
Eelco F. Wijdicks, MD, FAAN (Mayo Clinic W8)	Dr. Wijdicks has received publishing royalties from a publication relating to health care.
	No disclosure on file
Alejandro A. Rabinstein, MD, FAAN (Mayo Clinic)	Dr. Rabinstein has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boston Scientific. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Shionogi . Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Chiesi. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ceribell. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurocritical care/NCS-Springer. Dr. Rabinstein has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wolters/UptoDate. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for EBSCO/DynaMed. Dr. Rabinstein has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AHA. Dr. Rabinstein has received publishing royalties from a publication relating to health care. Dr. Rabinstein has received publishing royalties from a publication relating to health care. Dr. Rabinstein has received publishing royalties from a publication relating to health care. Dr. Rabinstein has received publishing royalties from a publication relating to health care.
Joana Moreira	Joana Moreira has received personal compensation for serving as an employee of BIAL.

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