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Long-term survival after out-of-hospital cardiac arrest (OHCA) has improved dramatically during the last several decades, due in large part to the “chain of survival” concept, which emphasizes cardiopulmonary resuscitation (CPR) and early defibrillation. In this prospective study, researchers assessed cognitive function in long-term (>6 months) survivors of OHCA due to ventricular fibrillation (VF).
Of 332 patients with OHCA due to VF in one Minnesota county from 1990 to 2008, 140 patients survived to hospital discharge and 79 were alive in 2009. Of these, 47 patients (mean age, 61) agreed to participate in the study. The median time between OHCA and neurological and neuropsychological testing was 7.8 years. The median call to shock time was 5.6 minutes. Mean test results for the study population were compared to age-standardized normal population values in the same county. Overall, the study population had generally positive neurological outcomes (ability to live independently; mean Mini-Mental State Examination scores similar to standard values) and preserved cognitive ability. Patients suffered minor long-term memory deficits, but these did not affect their ability to live independently. Delayed time to defibrillation and older age at time of arrest were not independent predictors of neurological impairment.
Mateen FJ et al. Long-term cognitive outcomes following out-of-hospital cardiac arrest: A population-based study. Neurology 2011 Oct 11; 77:1438.
Comment
These results reaffirm the importance of public education and the chain of survival, and they provide emergency physicians with valuable information for counseling patients and their family members.