Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark.
Department of Clinical Research, University of Southern Denmark Odense, Denmark; Department of Cardiology, Odense University Hospital, Odense, Denmark; Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark.
Resuscitation. 2024 Apr;197:110162. doi: 10.1016/j.resuscitation.2024.110162. Epub 2024 Mar 6.
Long-term cognitive decline after out-of-hospital cardiac arrest (OHCA) is still poorly understood. This study describes long-term observer-reported cognitive decline among Danish OHCA survivors, including differences in years since the event, and investigates characteristics and self-reported outcomes associated with observer-reported cognitive decline.
Adults who survived an OHCA from 2016 to 2019, and their relatives, completed the national DANish Cardiac Arrest Survivorship survey. Relatives completed the Informant Questionnaire on Cognitive Decline in the Elderly, Cardiac Arrest version (IQCODE-CA), the Hospital Anxiety and Depression Scale (HADS) and the World Health Organisation-Five Well-being index; and survivors completed the Two Simple Questions (everyday activities and mental recovery), the Modified Fatigue Impact Scale, HADS, and the Short World Health Organisation Disability Assessment Schedule 2.0. Potential associations between survivor characteristics and the IQCODE-CA were investigated using a multivariable logistic regression model. Self-reported outcomes among survivors and relatives, and the association with IQCODE-CA scores were investigated using separate logistic regression models.
Total median IQCODE-CA score was 3.04 (IQR: 3.00-3.27), with 47% having possible cognitive decline (score ≥ 3.04), consistent across time groups. Increasing age (OR 0.98, 95% CI: 0.97-0.99) and worse self-reported mental and physical outcomes for survivors and relatives, except 'everyday activities' were significantly associated with possible cognitive decline among survivors.
Nearly half of OHCA survivors may suffer long-term cognitive decline. Worse self-reported mental and physical outcomes among survivors and their relatives are associated with potential cognitive decline emphasising the need for post-OHCA care to include systematic neurocognitive assessment, tailored support and effective rehabilitation.
院外心脏骤停（OHCA）后长期认知能力下降仍知之甚少。本研究描述了丹麦 OHCA 幸存者的长期观察者报告认知能力下降情况，包括与事件发生时间的差异，并调查了与观察者报告认知能力下降相关的特征和自我报告结局。
2016 年至 2019 年 OHCA 幸存者及其亲属完成了全国丹麦心脏骤停生存者调查。亲属完成了认知衰退知情者问卷-心脏骤停版（IQCODE-CA）、医院焦虑和抑郁量表（HADS）和世界卫生组织-五维健康指数；幸存者完成了两个简单问题（日常活动和精神恢复）、改良疲劳影响量表、HADS 和简短世界卫生组织残疾评估量表 2.0。使用多变量逻辑回归模型调查幸存者特征与 IQCODE-CA 之间的潜在关联。使用单独的逻辑回归模型调查幸存者和亲属的自我报告结局，以及与 IQCODE-CA 评分的关联。
总中位数 IQCODE-CA 评分为 3.04（IQR：3.00-3.27），47%的患者可能存在认知能力下降（评分≥3.04），在不同时间组中保持一致。幸存者年龄增加（OR 0.98，95%CI：0.97-0.99）和幸存者及其亲属自我报告的精神和身体结局更差，除了“日常活动”外，与幸存者的可能认知能力下降显著相关。
近一半的 OHCA 幸存者可能长期认知能力下降。幸存者及其亲属自我报告的精神和身体结局更差与潜在认知能力下降相关，强调需要对 OHCA 后幸存者进行包括系统神经认知评估、量身定制的支持和有效的康复等护理。
