Long term functioning with poor neurologic outcome after cardiac arrest.

Autor: Nutma S; Department of Clinical Neurophysiology, Technical Medical Center, University of Twente, Enschede, the Netherlands; Department of Neurology, Medisch Spectrum Twente, Enschede, the Netherlands. Electronic address: s.nutma@mst.nl., Roesink O; Department of Health Sciences, Technical Medical Center, University of Twente, Enschede, the Netherlands; Department of Critical Care, Medisch Spectrum Twente, Enschede, the Netherlands., van Heugten CM; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Limburg Brain Injury Center, Maastricht University, Maastricht, the Netherlands., Hofmeijer J; Department of Clinical Neurophysiology, Technical Medical Center, University of Twente, Enschede, the Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, the Netherlands.
Jazyk: angličtina
Zdroj: Resuscitation [Resuscitation] 2024 Oct; Vol. 203, pp. 110375. Date of Electronic Publication: 2024 Aug 21.
DOI: 10.1016/j.resuscitation.2024.110375
Abstrakt: Aim: Around six percent of comatose patients after cardiac arrest have a Cerebral Performance Categories score of three (CPC3) at six months after the arrest, classified as severe neurological disability. There is limited knowledge regarding the likelihood of further recovery in the cognitive, emotional, and quality of life domains. We aimed to estimate the probability of recovery towards independency.
Methods: From a prospective Registry on comatose cardiac arrest patients admitted between 2013 and 2017 in two Dutch hospitals, we included patients with a CPC3 at six months after cardiac arrest. We followed patients up to November 2023. The primary outcome measure was the CPC score at time of follow up. Secondary outcomes were scores on questionnaires on cognition, mood, and quality of life according to the minimal dataset of acquired brain injury.
Results: In our cohort of 667 patients, 29 (4.3%) had a CPC3 score at six months (median age 68 years, 83% male). At a median time of eight years after cardiac arrest, sixteen patients had died. Twelve of thirteen alive patients still had a CPC3 score (92%) and one a CPC2 (8%). Seven patients agreed with further interviewing, one showed independency in activities of daily living (14%). Six patients (86%) reported limitations due to physical and one (14%) due to emotional problems. All had severe cognitive impairment. Six (86%) missed cognitive rehabilitation.
Conclusion: Our study shows that while the probability of recovery towards independence for patients with severe neurological disability at six months after cardiac arrest is limited, most long-term survivors are satisfied with their quality of life.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘J. Hofmeijer is supported by a Dutch governmental grant from ZonMW (grant number 95105001). J. Hofmeijer is supported by a grant from the Dutch Heart Association (grant number CEI 2018T070). Furthermore there is nothing to declare’.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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