Cognitive Recovery After Out-of-Hospital Cardiac Arrest: Insights Into Improvement Over 6 Months and the Role of Arrest Duration.

Abstract

BACKGROUND: Out-of-hospital cardiac arrest is a significant cause of mortality and morbidity worldwide. Although resuscitation advancements have increased survival, many survivors suffer cognitive impairments that affect their quality of life. Most research has focused on neurological outcomes, whereas little attention has been paid to cognitive function. The aim is to investigate the proportion of cognitive impairment in survivors of out-of-hospital cardiac arrest at discharge and 6 months after cardiac arrest and to investigate the association between the duration of cardiac arrest and level of cognitive function. METHODS: In this prospective cohort study, 184 survivors of out-of-hospital cardiac arrest were assessed using the Montreal Cognitive Assessment screening tool. Duration of cardiac arrest was defined by no flow, low flow, and time to return of spontaneous circulation. Multiple logistic regression analysis provided odds ratios (OR) and CI. RESULTS: Of 184 survivors assessed, 26% had normal cognitive function at discharge, increasing to 67% at 6 months (n=149). Median Montreal Cognitive Assessment score improved from 23 (Q25-Q75: 20-26) to 26 (Q25-Q75: 24-28). At 6 months, adjusted ORs per minute were 1.03 (95% CI, 1.00-1.07) for low flow and 1.03 (95% CI, 1.00-1.07) for time to return of spontaneous circulation, whereas associations at discharge were near null (aOR≈0.99). No significant association was found either at discharge or follow-up. CONCLUSIONS: Cognitive function improved considerably within 6 months following cardiac arrest, with the proportion of patients exhibiting normal cognitive function increasing from 26% to 67%. This study found no association between the duration of cardiac arrest and cognitive function.