Prospective evaluation of the relationship between cognition and recovery outcomes after cardiac arrest

Erik Blennow Nordström; Jeffrey L. Birk; Danielle A. Rojas; Tara St. Onge Sheehy; Camila I. Domínguez-Imbert Nieto; Gaspar J. Cruz; Maia ten Brink; William Vargas; Maria Karas; Sachin Agarwal

doi:10.1016/j.resuscitation.2024.110343

Prospective evaluation of the relationship between cognition and recovery outcomes after cardiac arrest

Erik Blennow Nordström, Jeffrey L. Birk, Danielle A. Rojas, Tara St. Onge Sheehy, Camila I. Domínguez-Imbert Nieto, Gaspar J. Cruz, Maia ten Brink, William Vargas, Maria Karas, Sachin Agarwal

Research output: Contribution to journal › Article › peer-review

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 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.

Original language	English
Article number	110343
Number of pages	9
Journal	Resuscitation
Volume	202
DOIs	https://doi.org/10.1016/j.resuscitation.2024.110343
Publication status	Published - 2024 Jul 31

Bibliographical note

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.

Subject classification (UKÄ)

Neurology
Applied Psychology
Cardiac and Cardiovascular Systems

Free keywords

cardiac arrest
cognitive impairment
functional recovery
fatigue
psychological distress

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.resuscitation.2024.110343

1 Abstract

Cognition as independent predictor of functional outcome after cardiac arrest
Blennow Nordström, E., Birk, J. L., St. Onge Sheehy, T., Domínguez-Imbert Nieto, C. I., Rojas, D. A., Cruz, G. J., ten Brink, M., Vargas, W. & Agarwal, S., 2024 Mar 25, p. 22.
Research output: Contribution to conference › Abstract › peer-review

Open Access

Cite this

@article{df21ca3bb745425c9dd80c6c9bb17f3e,

title = "Prospective evaluation of the relationship between cognition and recovery outcomes after cardiac arrest",

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 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.",

keywords = "cardiac arrest, cognitive impairment, functional recovery, fatigue, psychological distress, cardiac arrest, cognitive impairment, functional recovery, fatigue, psychological distress, outcome",

author = "{Blennow Nordstr{\"o}m}, Erik and Birk, {Jeffrey L.} and Rojas, {Danielle A.} and {St. Onge Sheehy}, Tara and {Dom{\'i}nguez-Imbert Nieto}, {Camila I.} and Cruz, {Gaspar J.} and {ten Brink}, Maia and William Vargas and Maria Karas and Sachin Agarwal",

note = "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.",

year = "2024",

month = jul,

day = "31",

doi = "10.1016/j.resuscitation.2024.110343",

language = "English",

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TY - JOUR

T1 - Prospective evaluation of the relationship between cognition and recovery outcomes after cardiac arrest

AU - Blennow Nordström, Erik

AU - Birk, Jeffrey L.

AU - Rojas, Danielle A.

AU - St. Onge Sheehy, Tara

AU - Domínguez-Imbert Nieto, Camila I.

AU - Cruz, Gaspar J.

AU - ten Brink, Maia

AU - Vargas, William

AU - Karas, Maria

AU - Agarwal, Sachin

N1 - 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.

PY - 2024/7/31

Y1 - 2024/7/31

N2 - 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.

AB - 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.

KW - cardiac arrest

KW - cognitive impairment

KW - functional recovery

KW - fatigue

KW - psychological distress

KW - cardiac arrest

KW - cognitive impairment

KW - functional recovery

KW - fatigue

KW - psychological distress

KW - outcome

U2 - 10.1016/j.resuscitation.2024.110343

DO - 10.1016/j.resuscitation.2024.110343

M3 - Article

C2 - 39094678

SN - 0300-9572

VL - 202

JO - Resuscitation

JF - Resuscitation

M1 - 110343

ER -

Prospective evaluation of the relationship between cognition and recovery outcomes after cardiac arrest

Abstract

Bibliographical note

Subject classification (UKÄ)

Free keywords

UN SDGs

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Research output

Cognition as independent predictor of functional outcome after cardiac arrest

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