PATTERNS OF COGNITIVE RECOVERY IN SUDDEN CARDIAC-ARREST SURVIVORS - THE PILOT-STUDY

OBJECTIVE: To determine the prevalence, type, severity, and natural ev olution of cognitive impairments in survivors of sudden cardiac arrest over time and to assess the relation of selected clinical and psychol ogic variables to those outcomes. DESIGN: Longitudinal with repeated m easures. Twenty-five consecutive patients underwent extensive neuropsy chologic testing during hospitalization within 3 weeks of their initia l cardiac arrest. Of these, 17 completed additional testing at 6 to 9 weeks, 12 to 15 weeks, and 22 to 25 weeks after the event. SETTING: Ca rdiac electrophysiologic services at a university teaching hospital, a community hospital, and home. OUTCOME VARIABLES: Orientation, attenti on, concentration, immediate recall, early retention, delayed recall, reasoning, motor speed, and motor regularity were measured. RESULTS: D uring hospitalization, 72% of the patients had mild to severe impairme nts in one or more cognitive areas. Memory, particularly delayed recal l, was the most common deficit. At 6 months after the arrest event, 29 % (5 of 17) of the patients continued to be impaired, and all had defi cits in delayed recall. Depression was significantly related to defici ts in attention and delayed recall al 6 months only. Time to postarres t awakening was the most reliable predictor of long-term cognitive fun ctioning in this patient sample. CONCLUSION: A significant minority of sudden death survivors incur long-term cognitive impairments, particu larly in delayed recall or short-term memory. The occurrence of long-t erm cognitive deficits in these patients can be estimated from the dur ation of unconsciousness after resuscitation (time-to-awakening).