Hammel Neurorehabilitation Clinic and University Research Centre, Hammel, Denmark.
Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.
Resuscitation. 2021 Aug;165:148-153. doi: 10.1016/j.resuscitation.2021.04.009. Epub 2021 Apr 19.
Affective and cognitive sequelae are frequently reported in cardiac arrest survivors; however, little is known about the risk factors. We assessed the hypothesis that self-reported affective and cognitive sequelae six months after OHCA may be associated with demography, acute care and cerebral outcome.
This is a sub-study of the multicentre "Target Temperature Management for 48 vs. 24 h and Neurologic Outcome after Out-of-Hospital Cardiac Arrest: A Randomised Clinical Trial" (the TTH48 trial) investigating the effect of prolonged TTM at 33 ± 1 °C. We invited patients with good outcome on the Cerebral Performances Categories (CPC score ≤ 2) to answer questionnaires on anxiety, depression, emotional distress, perceived stress and cognitive failures six months post OHCA.
In total 79 of 111 eligible patients were included in the analysis. There were no significant differences in baseline characteristics between the included group and the group lost to follow-up. Younger age was a negative predictor across all self-reported outcomes, even when controlling for gender, ROSC time, treatment allocation, cognitive impairment and global outcome (CPC 1 or 2). Female gender was a predictor of anxiety, though this should be interpreted cautiously as only eight women participated. A CPC score of 2 score was a negative predictor of self-reported affective outcomes, albeit not for self-reported cognitive failures.
Younger age was associated with higher levels of self-reported affective and cognitive sequelae six months post OHCA. Female gender may be associated with self-reported anxiety. A higher CPC score may be a proxy for self-reported affective sequelae.
心搏骤停幸存者常报告情感和认知后遗症,但对其危险因素知之甚少。我们假设,心搏骤停后 6 个月的自我报告情感和认知后遗症可能与人口统计学、急性治疗和脑结局有关。
这是一项多中心“目标温度管理 48 小时与 24 小时与院外心脏骤停后神经结局:随机临床试验”(TTH48 试验)的子研究,该研究调查了长时间 33°C±1°C TTM 的效果。我们邀请了预后良好的患者(Cerebral Performances Categories [CPC]评分≤2)在院外心脏骤停后 6 个月回答焦虑、抑郁、情绪困扰、感知压力和认知失败问卷。
总共 111 名合格患者中有 79 名纳入分析。纳入组和随访丢失组之间的基线特征无显著差异。在所有自我报告的结果中,年龄越小都是负面预测因素,即使控制了性别、ROSC 时间、治疗分配、认知障碍和总体结局(CPC 1 或 2)。女性是焦虑的预测因素,但由于只有 8 名女性参与,因此这一结果应谨慎解释。CPC 评分为 2 是自我报告情感结果的负面预测因素,但不是自我报告认知失败的预测因素。
年龄越小,院外心脏骤停后 6 个月自我报告的情感和认知后遗症水平越高。女性可能与自我报告的焦虑有关。较高的 CPC 评分可能是自我报告情感后遗症的替代指标。