Journal of the International Neuropsychological Society

Brief Communication

Cognitive and Functional Outcome After Out of Hospital Cardiac Arrest

Michael P. Alexandera1a2 c1, Ginette Laflechea3, David Schnyera4, Chun Lima1 and Mieke Verfaelliea3

a1 Cognitive Neurology Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

a2 Rotman Research Institute, Baycrest Hospital, Toronto, Ontario, Canada

a3 Memory Disorders Research Center, VA Boston Healthcare System and Boston University School of Medicine, Boston, Massachusetts

a4 Department of Psychology, University of Texas, Austin, Texas

Abstract

The nature of residual cognitive deficits after out of hospital cardiac arrest (OHCA) is incompletely described and has never been defined against a cardiac control (CC) group. The objective of this study is to examine neuropsychological outcomes 3 months after OHCA in patients in a “middle range” of acute severity. Thirty prospective OHCA admissions with coma >1 day and responsive but confused at 1 week, and 30 non-OHCA coronary care admissions were administered standard tests in five cognitive domains. OHCA subjects fell into two deficit profiles. One group (N = 20) had mild memory deficits and borderline psychomotor deficits compared to the CC group; 40% had returned to work. The other group (N = 10) had severe impairments in all domains. Coma duration was associated with group. Neither group had a high prevalence of depression. For most patients within the “middle range” of acute severity of OHCA, cognitive and functional outcomes at 3 months were encouraging. (JINS, 2011, 17, 364–368)

(Received June 20 2010)

(Revised November 24 2010)

(Accepted November 24 2010)

(Online publication January 04 2011)

Correspondence:

c1 Correspondence and reprint requests to: Michael P. Alexander, MD, Cognitive Neurology Unit, KS 253, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215. E-mail: malexand@bidmc.harvard.edu