Prospective evaluation of the relationship between cognition and recovery outcomes after cardiac arrest
Blennow Nordström, Erik LU
; Birk, Jeffrey L.
; Rojas, Danielle A.
; St. Onge Sheehy, Tara
; Domínguez-Imbert Nieto, Camila I.
; Cruz, Gaspar J.
; ten Brink, Maia
; Vargas, William
; Karas, Maria
and Agarwal, Sachin
(2024)
In Resuscitation
202.
- Abstract
- Purpose: Cognitive function is often impaired for cardiac arrest (CA) survivors due to hypoxic-ischemic brain injury. Whether cognitive impairment at hospital discharge is associated with recovery defined as functional status and fatigue measured at 1-month post-discharge is not known.
Methods: Consecutive CA patients admitted at an academic center (May 14, 2021–June 23, 2023) were assessed for cognitive impairment (modified Telephone Interview for Cognitive Status, TICS-m < 33) and depressive symptoms (8-item Patient Health Questionnaire) at hospital discharge. Poor functional status (primary outcome; modified Rankin Scale, mRS > 3) and fatigue severity (patient-reported outcome; Modified Fatigue Impact Scale) were assessed... (More) - Purpose: Cognitive function is often impaired for cardiac arrest (CA) survivors due to hypoxic-ischemic brain injury. Whether cognitive impairment at hospital discharge is associated with recovery defined as functional status and fatigue measured at 1-month post-discharge is not known.
Methods: Consecutive CA patients admitted at an academic center (May 14, 2021–June 23, 2023) were assessed for cognitive impairment (modified Telephone Interview for Cognitive Status, TICS-m < 33) and depressive symptoms (8-item Patient Health Questionnaire) at hospital discharge. Poor functional status (primary outcome; modified Rankin Scale, mRS > 3) and fatigue severity (patient-reported outcome; Modified Fatigue Impact Scale) were assessed 1-month post-discharge. Hierarchical regressions tested associations of cognitive function with outcomes.
Results: Of 112 participants (mean age 54.4 ± 14.8; 38% female; 43% White race, 20% Black race, 29% Hispanic ethnicity) completing discharge TICS-m, 63 (56%) had indicated cognitive impairment, and 68 (61%) had poor 1-month functional outcome. Worse discharge cognitive function was independently associated with a higher risk of poor 1-month functional outcome (OR = 0.88, 95% CI [0.79, 0.98], p = 0.02) after adjusting for age, education, sex, race, ethnicity, length of hospital stay, comorbidities, and depressive symptoms. Fatigue severity lacked significant associations with cognitive function, but was associated with depressive symptoms (B = 1.03 [0.00, 2.05], p = 0.04).
Conclusion: Cognitive function at discharge after CA was significantly and independently associated with functional outcome 1 month after hospital discharge. Psychological distress contributed to fatigue severity. This highlights the need for screening and addressing cognitive and emotional problems pre-hospital discharge. (Less) - Abstract (Swedish)
- Purpose: Cognitive function is often impaired for cardiac arrest (CA) survivors due to hypoxic-ischemic brain injury. Whether cognitive impairment at hospital discharge is associated with recovery defined as functional status and fatigue measured at 1-month post-discharge is not known.
Methods: Consecutive CA patients admitted at an academic center (May 14, 2021–June 23, 2023) were assessed for cognitive impairment (modified Telephone Interview for Cognitive Status, TICS-m < 33) and depressive symptoms (8-item Patient Health Questionnaire) at hospital discharge. Poor functional status (primary outcome; modified Rankin Scale, mRS > 3) and fatigue severity (patient-reported outcome; Modified Fatigue Impact Scale) were assessed... (More) - Purpose: Cognitive function is often impaired for cardiac arrest (CA) survivors due to hypoxic-ischemic brain injury. Whether cognitive impairment at hospital discharge is associated with recovery defined as functional status and fatigue measured at 1-month post-discharge is not known.
Methods: Consecutive CA patients admitted at an academic center (May 14, 2021–June 23, 2023) were assessed for cognitive impairment (modified Telephone Interview for Cognitive Status, TICS-m < 33) and depressive symptoms (8-item Patient Health Questionnaire) at hospital discharge. Poor functional status (primary outcome; modified Rankin Scale, mRS > 3) and fatigue severity (patient-reported outcome; Modified Fatigue Impact Scale) were assessed 1-month post-discharge. Hierarchical regressions tested associations of cognitive function with outcomes.
Results: Of 112 participants (mean age 54.4 ± 14.8; 38% female; 43% White race, 20% Black race, 29% Hispanic ethnicity) completing discharge TICS-m, 63 (56%) had indicated cognitive impairment, and 68 (61%) had poor 1-month functional outcome. Worse discharge cognitive function was independently associated with a higher risk of poor 1-month functional outcome (OR = 0.88, 95% CI [0.79, 0.98], p = 0.02) after adjusting for age, education, sex, race, ethnicity, length of hospital stay, comorbidities, and depressive symptoms. Fatigue severity lacked significant associations with cognitive function, but was associated with depressive symptoms (B = 1.03 [0.00, 2.05], p = 0.04).
Conclusion: Cognitive function at discharge after CA was significantly and independently associated with functional outcome 1 month after hospital discharge. Psychological distress contributed to fatigue severity. This highlights the need for screening and addressing cognitive and emotional problems pre-hospital discharge. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/df21ca3b-b745-425c-9dd8-0c6c9bb17f3e
- author
- Blennow Nordström, Erik
LU
; Birk, Jeffrey L.
; Rojas, Danielle A.
; St. Onge Sheehy, Tara
; Domínguez-Imbert Nieto, Camila I.
; Cruz, Gaspar J.
; ten Brink, Maia
; Vargas, William
; Karas, Maria
and Agarwal, Sachin
- organization
- publishing date
- 2024-07-31
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cardiac arrest, cognitive impairment, functional recovery, fatigue, psychological distress, cardiac arrest, cognitive impairment, functional recovery, fatigue, psychological distress, outcome
- in
- Resuscitation
- volume
- 202
- article number
- 110343
- pages
- 9 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:39094678
- ISSN
- 0300-9572
- DOI
- 10.1016/j.resuscitation.2024.110343
- language
- English
- LU publication?
- yes
- additional info
- We would like to thank all participants of the current study, Sean Mota for IT support, and Guixiao Ding, Cara L. McMurry, and Sung A. J. Lee for data coordination.
- id
- df21ca3b-b745-425c-9dd8-0c6c9bb17f3e
- date added to LUP
- 2024-08-09 16:17:54
- date last changed
- 2024-08-12 08:32:46
@article{df21ca3b-b745-425c-9dd8-0c6c9bb17f3e,
abstract = {{Purpose: Cognitive function is often impaired for cardiac arrest (CA) survivors due to hypoxic-ischemic brain injury. Whether cognitive impairment at hospital discharge is associated with recovery defined as functional status and fatigue measured at 1-month post-discharge is not known.<br/><br/>Methods: Consecutive CA patients admitted at an academic center (May 14, 2021–June 23, 2023) were assessed for cognitive impairment (modified Telephone Interview for Cognitive Status, TICS-m < 33) and depressive symptoms (8-item Patient Health Questionnaire) at hospital discharge. Poor functional status (primary outcome; modified Rankin Scale, mRS > 3) and fatigue severity (patient-reported outcome; Modified Fatigue Impact Scale) were assessed 1-month post-discharge. Hierarchical regressions tested associations of cognitive function with outcomes.<br/><br/>Results: Of 112 participants (mean age 54.4 ± 14.8; 38% female; 43% White race, 20% Black race, 29% Hispanic ethnicity) completing discharge TICS-m, 63 (56%) had indicated cognitive impairment, and 68 (61%) had poor 1-month functional outcome. Worse discharge cognitive function was independently associated with a higher risk of poor 1-month functional outcome (OR = 0.88, 95% CI [0.79, 0.98], p = 0.02) after adjusting for age, education, sex, race, ethnicity, length of hospital stay, comorbidities, and depressive symptoms. Fatigue severity lacked significant associations with cognitive function, but was associated with depressive symptoms (B = 1.03 [0.00, 2.05], p = 0.04).<br/><br/>Conclusion: Cognitive function at discharge after CA was significantly and independently associated with functional outcome 1 month after hospital discharge. Psychological distress contributed to fatigue severity. This highlights the need for screening and addressing cognitive and emotional problems pre-hospital discharge.}},
author = {{Blennow Nordström, Erik and Birk, Jeffrey L. and Rojas, Danielle A. and St. Onge Sheehy, Tara and Domínguez-Imbert Nieto, Camila I. and Cruz, Gaspar J. and ten Brink, Maia and Vargas, William and Karas, Maria and Agarwal, Sachin}},
issn = {{0300-9572}},
keywords = {{cardiac arrest; cognitive impairment; functional recovery; fatigue; psychological distress; cardiac arrest; cognitive impairment; functional recovery; fatigue; psychological distress; outcome}},
language = {{eng}},
month = {{07}},
publisher = {{Elsevier}},
series = {{Resuscitation}},
title = {{Prospective evaluation of the relationship between cognition and recovery outcomes after cardiac arrest}},
url = {{http://dx.doi.org/10.1016/j.resuscitation.2024.110343}},
doi = {{10.1016/j.resuscitation.2024.110343}},
volume = {{202}},
year = {{2024}},
}