Cognitive function in survivors of out-of-hospital cardiac arrest after target temperature management at 33°C versus 36°C

TY - JOUR

T1 - Cognitive function in survivors of out-of-hospital cardiac arrest after target temperature management at 33°C versus 36°C

AU - Lilja, Gisela

AU - Nielsen, Niklas

AU - Friberg, Hans

AU - Horn, Janneke

AU - Kjaergaard, Jesper

AU - Nilsson, Fredrik

AU - Pellis, Tommaso

AU - Wetterslev, Jørn

AU - Wise, Matt P

AU - Bosch, Frank

AU - Bro-Jeppesen, John

AU - Brunetti, Iole

AU - Buratti, Azul Forti

AU - Hassager, Christian

AU - Hofgren, Caisa

AU - Insorsi, Angelo

AU - Kuiper, Michael

AU - Martini, Alice

AU - Palmer, Nicki

AU - Rundgren, Malin

AU - Rylander, Christian

AU - van der Veen, Annelou

AU - Wanscher, Michael

AU - Watkins, Helen

AU - Cronberg, Tobias

N1 - © 2015 American Heart Association, Inc.

PY - 2015/4/14

Y1 - 2015/4/14

N2 - Background - Target temperature management is recommended as a neuroprotective strategy after out-of-hospital cardiac arrest. Potential effects of different target temperatures on cognitive impairment commonly described in survivors have not been investigated sufficiently. The primary aim of this study was to evaluate whether a target temperature of 33°C compared with 36°C was favorable for cognitive function; the secondary aim was to describe cognitive impairment in cardiac arrest survivors in general. Methods and Results - Study sites included 652 cardiac arrest survivors originally randomized and stratified for site to temperature control at 33°C or 36°C within the Target Temperature Management trial. Survival until 180 days after the arrest was 52% (33°C, n=178/328; 36°C, n=164/324). Survivors were invited to a face-to-face follow-up, and 287 cardiac arrest survivors (33°C, n=148/36°C, n=139) were assessed with tests for memory (Rivermead Behavioural Memory Test), executive functions (Frontal Assessment Battery), and attention/mental speed (Symbol Digit Modalities Test). A control group of 119 matched patients hospitalized for acute ST-segment-elevation myocardial infarction without cardiac arrest performed the same assessments. Half of the cardiac arrest survivors had cognitive impairment, which was mostly mild. Cognitive outcome did not differ (P>0.30) between the 2 temperature groups (33°C/36°C). Compared with control subjects with ST-segment-elevation myocardial infarction, attention/mental speed was more affected among cardiac arrest patients, but results for memory and executive functioning were similar. Conclusions - Cognitive function was comparable in survivors of out-of-hospital cardiac arrest when a temperature of 33° C and 36°C was targeted. Cognitive impairment detected in cardiac arrest survivors was also common in matched control subjects with ST-segment-elevation myocardial infarction not having had a cardiac arrest. Clinical Trial Registration-URL: . Unique identifier: NCT01946932.

AB - Background - Target temperature management is recommended as a neuroprotective strategy after out-of-hospital cardiac arrest. Potential effects of different target temperatures on cognitive impairment commonly described in survivors have not been investigated sufficiently. The primary aim of this study was to evaluate whether a target temperature of 33°C compared with 36°C was favorable for cognitive function; the secondary aim was to describe cognitive impairment in cardiac arrest survivors in general. Methods and Results - Study sites included 652 cardiac arrest survivors originally randomized and stratified for site to temperature control at 33°C or 36°C within the Target Temperature Management trial. Survival until 180 days after the arrest was 52% (33°C, n=178/328; 36°C, n=164/324). Survivors were invited to a face-to-face follow-up, and 287 cardiac arrest survivors (33°C, n=148/36°C, n=139) were assessed with tests for memory (Rivermead Behavioural Memory Test), executive functions (Frontal Assessment Battery), and attention/mental speed (Symbol Digit Modalities Test). A control group of 119 matched patients hospitalized for acute ST-segment-elevation myocardial infarction without cardiac arrest performed the same assessments. Half of the cardiac arrest survivors had cognitive impairment, which was mostly mild. Cognitive outcome did not differ (P>0.30) between the 2 temperature groups (33°C/36°C). Compared with control subjects with ST-segment-elevation myocardial infarction, attention/mental speed was more affected among cardiac arrest patients, but results for memory and executive functioning were similar. Conclusions - Cognitive function was comparable in survivors of out-of-hospital cardiac arrest when a temperature of 33° C and 36°C was targeted. Cognitive impairment detected in cardiac arrest survivors was also common in matched control subjects with ST-segment-elevation myocardial infarction not having had a cardiac arrest. Clinical Trial Registration-URL: . Unique identifier: NCT01946932.

KW - Aged

KW - Body Temperature

KW - Cognition

KW - Electrocardiography

KW - Europe

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Hypothermia, Induced

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Out-of-Hospital Cardiac Arrest

KW - Patient Outcome Assessment

KW - Risk Factors

KW - Treatment Outcome

U2 - 10.1161/circulationaha.114.014414

DO - 10.1161/circulationaha.114.014414

M3 - Journal article

C2 - 25681466

SN - 0009-7322

VL - 131

SP - 1340

EP - 1349

JO - Circulation

JF - Circulation

ER -