1 Neuropsychological Outcome After Cardiac Arrest: Results from a Sub-study of the Targeted Hypothermia Versus Targeted Normothermia After Out-of-hospital Cardiac Arrest (TTM2) Trial Article Swipe
Erik Nordström
,
Susanna Vestberg
,
Lars Evald
,
Marco Mion
,
Magnus Segerström
,
Susann Ullén
,
John Bro‐Jeppesen
,
Hans Friberg
,
Katarina Heimburg
,
Anders Morten Grejs
,
Thomas Keeble
,
Hans Kirkegaard
,
Hanna Ljung
,
Sofia Rose
,
Matt P. Wise
,
Christian Rylander
,
Johan Undén
,
Niklas Nielsen
,
Tobias Cronberg
,
Gisela Lilja
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1017/s1355617723009815
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1017/s1355617723009815
Objective: To describe cognitive impairment in out-of-hospital cardiac arrest (OHCA) survivors, with the hypothesis that OHCA survivors would perform significantly worse on neuropsychological tests of cognition than controls with acute myocardial infarction (MI). Another aim was to investigate the relationship between cognitive performance and the associated factors of emotional problems, fatigue, insomnia, and cardiovascular risk factors following OHCA. Participants and Methods: This was a prospective case control sub-study of The Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial. Eight of 61 TTM2-sites in Sweden, Denmark, and the United Kingdom included adults with OHCA of presumed cardiac or unknown cause. A matched non-arrest control group with acute MI was recruited. We administered an extensive neuropsychological assessment at approximately 7 months post-cardiac event, including a neuropsychological test battery and questionnaires on anxiety, depression, fatigue, and insomnia, and collected information on the cardiovascular risk factors hypertension and diabetes. Z -scores of individual tests were converted to neuropsychological composite scores per cognitive domain (verbal, visual/constructive, working memory, episodic memory, processing speed, executive functions). Between-group differences on the neuropsychological composite scores were investigated with linear regression. Associations between anxiety, depression, fatigue, insomnia, hypertension, diabetes, and the neuropsychological composite scores among OHCA survivors were calculated with Spearman’s rho. Results: Of 184 eligible OHCA survivors, 108 were included (mean age = 62, 88% male), with 92 MI controls enrolled (mean age = 64, 89% male). Amongst OHCA survivors, 29% performed z 2 cognitive domains, and 14% performed z 1 cognitive domain. OHCA survivors performed significantly worse than MI controls in episodic memory (mean difference, MD = -0.37, 95% confidence intervals [-0.61, -0.12]), verbal (MD = -0.34 [-0.62, -0.07]), and visual/constructive functions (MD = -0.26 [-0.47, -0.04]) on linear regressions adjusted for educational attainment and sex. When additionally adjusting for anxiety, depression, fatigue, insomnia, hypertension, and diabetes, processing speed (MD = -0.41 [-0.74, -0.09]) and executive functions (MD = -0.69 [-1.13, -0.24]) were also worse following OHCA. Depressive symptoms were associated with worse executive functions (rs = -0.37, p <0.001) and worse processing speed (rs = -0.27, p = 0.01) post-OHCA. Anxiety symptoms (rs = -0.21, p = 0.01) and general fatigue (rs = -0.24, p = 0.01) were associated with worse executive functions. Diabetes was associated with worse processing speed (rs = -0.20, p = 0.03), visual/constructive (rs = -0.29, p <0.001) and executive functions (rs = -0.25, p = 0.02), while hypertension and insomnia were not significantly associated with neuropsychological test performance. Conclusions: Cognitive impairment is generally mild following OHCA, but most pronounced in episodic memory, executive functions, and processing speed. OHCA survivors performed worse than MI controls. We suggest that a post-OHCA follow-up service should screen for cognitive impairment, emotional problems, and fatigue.
Related Topics
Concepts
Medicine
Anxiety
Neuropsychology
Depression (economics)
Neuropsychological assessment
Internal medicine
Cognition
Psychiatry
Macroeconomics
Economics
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1017/s1355617723009815
- https://www.cambridge.org/core/services/aop-cambridge-core/content/view/DB632BBC5986A65D977DE87A358B5015/S1355617723009815a.pdf/div-class-title-1-neuropsychological-outcome-after-cardiac-arrest-results-from-a-sub-study-of-the-targeted-hypothermia-versus-targeted-normothermia-after-out-of-hospital-cardiac-arrest-ttm2-trial-div.pdf
- OA Status
- bronze
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4390079109
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4390079109Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1017/s1355617723009815Digital Object Identifier
- Title
-
1 Neuropsychological Outcome After Cardiac Arrest: Results from a Sub-study of the Targeted Hypothermia Versus Targeted Normothermia After Out-of-hospital Cardiac Arrest (TTM2) TrialWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-11-01Full publication date if available
- Authors
-
Erik Nordström, Susanna Vestberg, Lars Evald, Marco Mion, Magnus Segerström, Susann Ullén, John Bro‐Jeppesen, Hans Friberg, Katarina Heimburg, Anders Morten Grejs, Thomas Keeble, Hans Kirkegaard, Hanna Ljung, Sofia Rose, Matt P. Wise, Christian Rylander, Johan Undén, Niklas Nielsen, Tobias Cronberg, Gisela LiljaList of authors in order
- Landing page
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https://doi.org/10.1017/s1355617723009815Publisher landing page
- PDF URL
-
https://www.cambridge.org/core/services/aop-cambridge-core/content/view/DB632BBC5986A65D977DE87A358B5015/S1355617723009815a.pdf/div-class-title-1-neuropsychological-outcome-after-cardiac-arrest-results-from-a-sub-study-of-the-targeted-hypothermia-versus-targeted-normothermia-after-out-of-hospital-cardiac-arrest-ttm2-trial-div.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
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bronzeOpen access status per OpenAlex
- OA URL
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https://www.cambridge.org/core/services/aop-cambridge-core/content/view/DB632BBC5986A65D977DE87A358B5015/S1355617723009815a.pdf/div-class-title-1-neuropsychological-outcome-after-cardiac-arrest-results-from-a-sub-study-of-the-targeted-hypothermia-versus-targeted-normothermia-after-out-of-hospital-cardiac-arrest-ttm2-trial-div.pdfDirect OA link when available
- Concepts
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Medicine, Anxiety, Neuropsychology, Depression (economics), Neuropsychological assessment, Internal medicine, Cognition, Psychiatry, Macroeconomics, EconomicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
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10Other works algorithmically related by OpenAlex
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