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Cognition as independent predictor of functional outcome after cardiac arrest

Blennow Nordström, Erik LU orcid ; Birk, Jeffrey L. ; St. Onge Sheehy, Tara ; Domínguez-Imbert Nieto, Camila I. ; Rojas, Danielle A. ; Cruz, Gaspar J. ; ten Brink, Maia ; Vargas, William and Agarwal, Sachin (2024) The 15th Nordic Meeting in Neuropsychology p.22-22
Abstract
Background
Cognitive function is often impaired for cardiac arrest (CA) survivors as an effect of hypoxic-ischemic brain injury. An important factor in CA recovery is global functional outcome, commonly assessed with the modified Rankin Scale (mRS). Little is known about the role of cognition as a potential predictor of outcome following CA.

Objective
To investigate cognitive function at hospital discharge as a predictor of global functional outcome at 1-month post-discharge. Our hypothesis was that cognitive function would be a significant independent predictor of functional outcome after adjusting for sociodemographic and medical factors.

Method
Adult CA survivors were recruited at Columbia University... (More)
Background
Cognitive function is often impaired for cardiac arrest (CA) survivors as an effect of hypoxic-ischemic brain injury. An important factor in CA recovery is global functional outcome, commonly assessed with the modified Rankin Scale (mRS). Little is known about the role of cognition as a potential predictor of outcome following CA.

Objective
To investigate cognitive function at hospital discharge as a predictor of global functional outcome at 1-month post-discharge. Our hypothesis was that cognitive function would be a significant independent predictor of functional outcome after adjusting for sociodemographic and medical factors.

Method
Adult CA survivors were recruited at Columbia University Medical Center, New York, in the ongoing Psychological Predictors of Recovery after Acute Cardiac Events (PACE) Study. Cognition was measured with the Telephone Interview for Cognitive Status Modified (TICS-M) at hospital discharge, and mRS was the functional outcome scale 1 month later. We analyzed our data with stepwise logistic regressions: 1) unadjusted; 2) adjusted for age, sex, educational attainment, race/ethnicity, time from CA to return of spontaneous circulation; 3) additionally adjusted for depressive symptoms (Patient Health Questionnaire-8) at
discharge.

Results
In our cohort of 112 participants (median age=56, 62% male) with completed TICS-M at discharge, 71% scored <36 indicating cognitive impairment, and 61% had mRS scores >3 equivalent to poor functional outcome at 1-month. Higher TICS-M scores at discharge independently predicted lower risk of poor 1-month mRS scores in all regression models, OR=0.84 (95% CI [0.74, 0.94]), p <.01 (model 3). Women had a greater risk of poor functional outcome. Hispanic participants had greater chances of good functional outcome.

Conclusion
Indicated cognitive impairment was a significant independent predictor of poor functional outcome after CA beyond the effects of demographics and CA downtime. This emphasizes the importance of targeting cognition in rehabilitation interventions, but also to identify other risk factors that could impede post-CA recovery. (Less)
Abstract (Swedish)
Background
Cognitive function is often impaired for cardiac arrest (CA) survivors as an effect of hypoxic-ischemic brain injury. An important factor in CA recovery is global functional outcome, commonly assessed with the modified Rankin Scale (mRS). Little is known about the role of cognition as a potential predictor of outcome following CA.

Objective
To investigate cognitive function at hospital discharge as a predictor of global functional outcome at 1-month post-discharge. Our hypothesis was that cognitive function would be a significant independent predictor of functional outcome after adjusting for sociodemographic and medical factors.

Method
Adult CA survivors were recruited at Columbia University... (More)
Background
Cognitive function is often impaired for cardiac arrest (CA) survivors as an effect of hypoxic-ischemic brain injury. An important factor in CA recovery is global functional outcome, commonly assessed with the modified Rankin Scale (mRS). Little is known about the role of cognition as a potential predictor of outcome following CA.

Objective
To investigate cognitive function at hospital discharge as a predictor of global functional outcome at 1-month post-discharge. Our hypothesis was that cognitive function would be a significant independent predictor of functional outcome after adjusting for sociodemographic and medical factors.

Method
Adult CA survivors were recruited at Columbia University Medical Center, New York, in the ongoing Psychological Predictors of Recovery after Acute Cardiac Events (PACE) Study. Cognition was measured with the Telephone Interview for Cognitive Status Modified (TICS-M) at hospital discharge, and mRS was the functional outcome scale 1 month later. We analyzed our data with stepwise logistic regressions: 1) unadjusted; 2) adjusted for age, sex, educational attainment, race/ethnicity, time from CA to return of spontaneous circulation; 3) additionally adjusted for depressive symptoms (Patient Health Questionnaire-8) at
discharge.

Results
In our cohort of 112 participants (median age=56, 62% male) with completed TICS-M at discharge, 71% scored <36 indicating cognitive impairment, and 61% had mRS scores >3 equivalent to poor functional outcome at 1-month. Higher TICS-M scores at discharge independently predicted lower risk of poor 1-month mRS scores in all regression models, OR=0.84 (95% CI [0.74, 0.94]), p <.01 (model 3). Women had a greater risk of poor functional outcome. Hispanic participants had greater chances of good functional outcome.

Conclusion
Indicated cognitive impairment was a significant independent predictor of poor functional outcome after CA beyond the effects of demographics and CA downtime. This emphasizes the importance of targeting cognition in rehabilitation interventions, but also to identify other risk factors that could impede post-CA recovery. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to conference
publication status
published
subject
keywords
Anoxia/hypoxia, Cognition, Longitudinal, Anoxia/hypoxia, Cognition, Longitudinal
pages
22 - 22
conference name
The 15th Nordic Meeting in Neuropsychology
conference location
Trondheim, Norway
conference dates
2024-08-27 - 2024-08-30
language
English
LU publication?
yes
id
7db500b4-e624-463b-8fa6-60d462443a28
alternative location
https://nordicmeeting.com/download/Abstract%20Book_V7.pdf
date added to LUP
2024-08-28 22:29:19
date last changed
2024-08-29 07:11:25
@misc{7db500b4-e624-463b-8fa6-60d462443a28,
  abstract     = {{Background<br/>Cognitive function is often impaired for cardiac arrest (CA) survivors as an effect of hypoxic-ischemic brain injury. An important factor in CA recovery is global functional outcome, commonly assessed with the modified Rankin Scale (mRS). Little is known about the role of cognition as a potential predictor of outcome following CA.<br/><br/>Objective<br/>To investigate cognitive function at hospital discharge as a predictor of global functional outcome at 1-month post-discharge. Our hypothesis was that cognitive function would be a significant independent predictor of functional outcome after adjusting for sociodemographic and medical factors.<br/><br/>Method<br/>Adult CA survivors were recruited at Columbia University Medical Center, New York, in the ongoing Psychological Predictors of Recovery after Acute Cardiac Events (PACE) Study. Cognition was measured with the Telephone Interview for Cognitive Status Modified (TICS-M) at hospital discharge, and mRS was the functional outcome scale 1 month later. We analyzed our data with stepwise logistic regressions: 1) unadjusted; 2) adjusted for age, sex, educational attainment, race/ethnicity, time from CA to return of spontaneous circulation; 3) additionally adjusted for depressive symptoms (Patient Health Questionnaire-8) at<br/>discharge.<br/><br/>Results<br/>In our cohort of 112 participants (median age=56, 62% male) with completed TICS-M at discharge, 71% scored &lt;36 indicating cognitive impairment, and 61% had mRS scores &gt;3 equivalent to poor functional outcome at 1-month. Higher TICS-M scores at discharge independently predicted lower risk of poor 1-month mRS scores in all regression models, OR=0.84 (95% CI [0.74, 0.94]), p &lt;.01 (model 3). Women had a greater risk of poor functional outcome. Hispanic participants had greater chances of good functional outcome.<br/><br/>Conclusion<br/>Indicated cognitive impairment was a significant independent predictor of poor functional outcome after CA beyond the effects of demographics and CA downtime. This emphasizes the importance of targeting cognition in rehabilitation interventions, but also to identify other risk factors that could impede post-CA recovery.}},
  author       = {{Blennow Nordström, Erik and Birk, Jeffrey L. and St. Onge Sheehy, Tara and Domínguez-Imbert Nieto, Camila I. and Rojas, Danielle A. and Cruz, Gaspar J. and ten Brink, Maia and Vargas, William and Agarwal, Sachin}},
  keywords     = {{Anoxia/hypoxia; Cognition; Longitudinal; Anoxia/hypoxia; Cognition; Longitudinal}},
  language     = {{eng}},
  month        = {{03}},
  pages        = {{22--22}},
  title        = {{Cognition as independent predictor of functional outcome after cardiac arrest}},
  url          = {{https://nordicmeeting.com/download/Abstract%20Book_V7.pdf}},
  year         = {{2024}},
}