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  • Blennow Nordström, ErikLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Brain Injury After Cardiac Arrest,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital (författare)

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

  • Artikel/kapitelEngelska2023

Förlag, utgivningsår, omfång ...

  • BioMed Central (BMC),2023
  • electronicrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-515718
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-515718URI
  • https://doi.org/10.1186/s13054-023-04617-0DOI
  • https://lup.lub.lu.se/record/266d7df2-4d1e-4c53-af94-39d7b4390388URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • BACKGROUND: Cognitive impairment is common following out-of-hospital cardiac arrest (OHCA), but the nature of the impairment is poorly understood. Our objective was to describe cognitive impairment in 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.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. At approximately 7 months post-event, we administered an extensive neuropsychological test battery and questionnaires on anxiety, depression, fatigue, and insomnia, and collected information on the cardiovascular risk factors hypertension and diabetes.RESULTS: Of 184 eligible OHCA survivors, 108 were included, with 92 MI controls enrolled. Amongst OHCA survivors, 29% performed z-score ≤ - 1 (at least borderline-mild impairment) in ≥ 2 cognitive domains, 14% performed z-score ≤ - 2 (major impairment) in ≥ 1 cognitive domain while 54% performed without impairment in any domain. Impairment was most pronounced in episodic memory, executive functions, and processing speed. 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, executive functions (MD = - 0.44 [- 0.82, - 0.06]) were also worse following OHCA. Diabetes, symptoms of anxiety, depression, and fatigue were significantly associated with worse cognitive performance.CONCLUSIONS: In our study population, cognitive impairment was generally mild following OHCA. OHCA survivors performed worse than MI controls in 3 of 6 domains. These results support current guidelines that a post-OHCA follow-up service should screen for cognitive impairment, emotional problems, and fatigue.TRIAL REGISTRATION: ClinicalTrials.gov, NCT03543371. Registered 1 June 2018.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Vestberg, SusannaLund University,Lunds universitet,Psykiatri, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,LU profilområde: Proaktivt åldrande,Lunds universitets profilområden,Psychiatry (Lund),Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,LU Profile Area: Proactive Ageing,Lund University Profile areas(Swepub:lu)psyk-vsu (författare)
  • Evald, LarsRegionshospitalet Hammel Neurocenter (författare)
  • Mion, MarcoAnglia Ruskin University,Aarhus University Hospital (författare)
  • Segerström, MagnusSahlgrenska University Hospital (författare)
  • Ullén, SusannSkåne University Hospital(Swepub:lu)su7040ul (författare)
  • Bro-Jeppesen, JohnAarhus University Hospital (författare)
  • Friberg, HansLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital(Swepub:lu)efor-hfr (författare)
  • Heimburg, KatarinaLund University,Lunds universitet,Brain Injury After Cardiac Arrest,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital(Swepub:lu)ka7876he (författare)
  • Grejs, Anders M. (författare)
  • Keeble, Thomas R.The Essex Cardiothoracic Centre (författare)
  • Kirkegaard, HansAarhus University Hospital (författare)
  • Ljung, HannaLund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Epilepsicentrum,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Epilepsy Center,Section IV,Department of Clinical Sciences, Lund,Skåne University Hospital(Swepub:lu)med-hlj (författare)
  • Rose, SofiaCardiff and Vale University Health Board (författare)
  • Wise, Matthew P.University Hospital of Wales (författare)
  • Rylander, ChristianUppsala University,Uppsala universitet,Anestesiologi och intensivvård(Swepub:uu)chrry684 (författare)
  • Undén, JohanLund University,Lunds universitet,Anestesiologi och intensivvård,Forskargrupper vid Lunds universitet,Anaesthesiology and Intensive Care Medicine,Lund University Research Groups,Halmstad County Hospital,Skåne University Hospital(Swepub:lu)neur-jun (författare)
  • Nielsen, NiklasLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SEBRA Sepsis and Bacterial Resistance Alliance,Center for cardiac arrest,Lund University Research Groups,Helsingborg Hospital(Swepub:lu)med-nni (författare)
  • Cronberg, TobiasLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Brain Injury After Cardiac Arrest,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital(Swepub:lu)efor-tcr (författare)
  • Lilja, GiselaLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Brain Injury After Cardiac Arrest,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-gal (författare)
  • Centrum för hjärtstoppForskargrupper vid Lunds universitet (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Critical Care: BioMed Central (BMC)27:11364-85351466-609X

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