Cognitive Function in Survivors of Out-of-Hospital Cardiac Arrest After Target Temperature Management at 33ºC Versus 36ºC

Gisela Lilja; Niklas Nielsen; Hans Friberg; Janneke Horn; Jesper Kjaergaard; Lars Anders Fredrik Nilsson; Tommaso Pellis; Jørn Wetterslev; Matt P Wise; Frank Bosch; John Bro-Jeppesen; Iole Brunetti; Azul Forti Buratti; Christian Hassager; Caisa Hofgren; Angelo Insorsi; Michael Kuiper; Alice Martini; Nicki Palmer; Malin Rundgren; Christian Rylander; Annelou van der Veen; Michael Wanscher; Helen Watkins; Tobias Cronberg

doi:10.1161/CIRCULATIONAHA.114.014414

Cognitive Function in Survivors of Out-of-Hospital Cardiac Arrest After Target Temperature Management at 33ºC Versus 36ºC

Gisela Lilja, Niklas Nielsen, Hans Friberg, Janneke Horn, Jesper Kjaergaard, Lars Anders Fredrik Nilsson, Tommaso Pellis, Jørn Wetterslev, Matt P Wise, Frank Bosch, John Bro-Jeppesen, Iole Brunetti, Azul Forti Buratti, Christian Hassager, Caisa Hofgren, Angelo Insorsi, Michael Kuiper, Alice Martini, Nicki Palmer, Malin RundgrenChristian Rylander, Annelou van der Veen, Michael Wanscher, Helen Watkins, Tobias Cronberg

Copenhagen Trial Unit Rigshospitalet

128 Citationer (Scopus)

Abstrakt

BACKGROUND: -Target temperature management is recommended as a neuro-protective strategy after out-of-hospital cardiac arrest. Potential effects of different target temperatures on cognitive impairment commonly described in survivors are not sufficiently investigated. The primary aim of this study was to evaluate whether a target temperature of 33ºC compared to 36ºC was favourable for cognitive function, and secondary to describe cognitive impairment in cardiac arrest survivors in general.

METHODS AND RESULTS: -Study-sites included 652 cardiac arrest survivors originally randomized and stratified for site to temperature control at 33ºC or 36ºC within the Target Temperature Management trial. Survival until 180 days after the arrest was 52% (33ºC n=178/328 36ºC n=164/324). Survivors were invited to a face-to-face follow-up and 287 cardiac arrest survivors (33ºC n=148/36ºC n=139) were assessed with tests for memory (Rivermead Behavioural Memory Test), executive functions (Frontal Assessment Battery) and attention/mental speed (Symbol Digit Modalities Test). A control-group of 119 matched patients hospitalized for acute ST-elevation myocardial infarction (STEMI) without cardiac arrest performed the same assessments. Half of the cardiac arrest survivors had cognitive impairment, which was mostly mild. Cognitive outcome did not differ (p >0.30) between the two temperature groups (33ºC/36ºC). Compared to STEMI-controls attention/mental speed was more affected among cardiac arrest patients, but results for memory and executive functioning were similar.

CONCLUSIONS: -Cognitive function was comparable in survivors of out-of-hospital cardiac arrest when targeting a temperature of 33ºC and 36ºC. Cognitive impairment detected in cardiac arrest survivors was also common in matched STEMI-controls not having had a cardiac arrest. Clinical Trial Registration Information-ClinicalTrials.gov. Identifier: NCT01946932.

Originalsprog	Engelsk
Tidsskrift	Circulation (Baltimore)
Vol/bind	131
Udgave nummer	15
Sider (fra-til)	1340-9
ISSN	0009-7322
DOI	https://doi.org/10.1161/CIRCULATIONAHA.114.014414
Status	Udgivet - 13 feb. 2015

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10.1161/CIRCULATIONAHA.114.014414

Citationsformater

Lilja, G., Nielsen, N., Friberg, H., Horn, J., Kjaergaard, J., Nilsson, L. A. F., Pellis, T., Wetterslev, J., Wise, M. P., Bosch, F., Bro-Jeppesen, J., Brunetti, I., Forti Buratti, A., Hassager, C., Hofgren, C., Insorsi, A., Kuiper, M., Martini, A., Palmer, N., ... Cronberg, T. (2015). Cognitive Function in Survivors of Out-of-Hospital Cardiac Arrest After Target Temperature Management at 33ºC Versus 36ºC. Circulation (Baltimore), 131(15), 1340-9. https://doi.org/10.1161/CIRCULATIONAHA.114.014414

Lilja, G, Nielsen, N, Friberg, H, Horn, J, Kjaergaard, J, Nilsson, LAF, Pellis, T, Wetterslev, J, Wise, MP, Bosch, F, Bro-Jeppesen, J, Brunetti, I, Forti Buratti, A, Hassager, C, Hofgren, C, Insorsi, A, Kuiper, M, Martini, A, Palmer, N, Rundgren, M, Rylander, C, van der Veen, A, Wanscher, M, Watkins, H & Cronberg, T 2015, 'Cognitive Function in Survivors of Out-of-Hospital Cardiac Arrest After Target Temperature Management at 33ºC Versus 36ºC', Circulation (Baltimore), bind 131, nr. 15, s. 1340-9. https://doi.org/10.1161/CIRCULATIONAHA.114.014414

@article{6d85e220ec0240f696388b1a9ccc1276,

title = "Cognitive Function in Survivors of Out-of-Hospital Cardiac Arrest After Target Temperature Management at 33ºC Versus 36ºC",

abstract = "BACKGROUND: -Target temperature management is recommended as a neuro-protective strategy after out-of-hospital cardiac arrest. Potential effects of different target temperatures on cognitive impairment commonly described in survivors are not sufficiently investigated. The primary aim of this study was to evaluate whether a target temperature of 33ºC compared to 36ºC was favourable for cognitive function, and secondary to describe cognitive impairment in cardiac arrest survivors in general.METHODS AND RESULTS: -Study-sites included 652 cardiac arrest survivors originally randomized and stratified for site to temperature control at 33ºC or 36ºC within the Target Temperature Management trial. Survival until 180 days after the arrest was 52% (33ºC n=178/328 36ºC n=164/324). Survivors were invited to a face-to-face follow-up and 287 cardiac arrest survivors (33ºC n=148/36ºC n=139) were assessed with tests for memory (Rivermead Behavioural Memory Test), executive functions (Frontal Assessment Battery) and attention/mental speed (Symbol Digit Modalities Test). A control-group of 119 matched patients hospitalized for acute ST-elevation myocardial infarction (STEMI) without cardiac arrest performed the same assessments. Half of the cardiac arrest survivors had cognitive impairment, which was mostly mild. Cognitive outcome did not differ (p >0.30) between the two temperature groups (33ºC/36ºC). Compared to STEMI-controls attention/mental speed was more affected among cardiac arrest patients, but results for memory and executive functioning were similar.CONCLUSIONS: -Cognitive function was comparable in survivors of out-of-hospital cardiac arrest when targeting a temperature of 33ºC and 36ºC. Cognitive impairment detected in cardiac arrest survivors was also common in matched STEMI-controls not having had a cardiac arrest. Clinical Trial Registration Information-ClinicalTrials.gov. Identifier: NCT01946932.",

author = "Gisela Lilja and Niklas Nielsen and Hans Friberg and Janneke Horn and Jesper Kjaergaard and Nilsson, {Lars Anders Fredrik} and Tommaso Pellis and J{\o}rn Wetterslev and Wise, {Matt P} and Frank Bosch and John Bro-Jeppesen and Iole Brunetti and {Forti Buratti}, Azul and Christian Hassager and Caisa Hofgren and Angelo Insorsi and Michael Kuiper and Alice Martini and Nicki Palmer and Malin Rundgren and Christian Rylander and {van der Veen}, Annelou and Michael Wanscher and Helen Watkins and Tobias Cronberg",

year = "2015",

month = feb,

day = "13",

doi = "10.1161/CIRCULATIONAHA.114.014414",

language = "English",

volume = "131",

pages = "1340--9",

journal = "Circulation (Baltimore)",

issn = "0009-7322",

publisher = "Lippincott Williams & Wilkins",

number = "15",

}

TY - JOUR

T1 - Cognitive Function in Survivors of Out-of-Hospital Cardiac Arrest After Target Temperature Management at 33ºC Versus 36ºC

AU - Lilja, Gisela

AU - Nielsen, Niklas

AU - Friberg, Hans

AU - Horn, Janneke

AU - Kjaergaard, Jesper

AU - Nilsson, Lars Anders Fredrik

AU - Pellis, Tommaso

AU - Wetterslev, Jørn

AU - Wise, Matt P

AU - Bosch, Frank

AU - Bro-Jeppesen, John

AU - Brunetti, Iole

AU - Forti Buratti, Azul

AU - Hassager, Christian

AU - Hofgren, Caisa

AU - Insorsi, Angelo

AU - Kuiper, Michael

AU - Martini, Alice

AU - Palmer, Nicki

AU - Rundgren, Malin

AU - Rylander, Christian

AU - van der Veen, Annelou

AU - Wanscher, Michael

AU - Watkins, Helen

AU - Cronberg, Tobias

PY - 2015/2/13

Y1 - 2015/2/13

N2 - BACKGROUND: -Target temperature management is recommended as a neuro-protective strategy after out-of-hospital cardiac arrest. Potential effects of different target temperatures on cognitive impairment commonly described in survivors are not sufficiently investigated. The primary aim of this study was to evaluate whether a target temperature of 33ºC compared to 36ºC was favourable for cognitive function, and secondary to describe cognitive impairment in cardiac arrest survivors in general.METHODS AND RESULTS: -Study-sites included 652 cardiac arrest survivors originally randomized and stratified for site to temperature control at 33ºC or 36ºC within the Target Temperature Management trial. Survival until 180 days after the arrest was 52% (33ºC n=178/328 36ºC n=164/324). Survivors were invited to a face-to-face follow-up and 287 cardiac arrest survivors (33ºC n=148/36ºC n=139) were assessed with tests for memory (Rivermead Behavioural Memory Test), executive functions (Frontal Assessment Battery) and attention/mental speed (Symbol Digit Modalities Test). A control-group of 119 matched patients hospitalized for acute ST-elevation myocardial infarction (STEMI) without cardiac arrest performed the same assessments. Half of the cardiac arrest survivors had cognitive impairment, which was mostly mild. Cognitive outcome did not differ (p >0.30) between the two temperature groups (33ºC/36ºC). Compared to STEMI-controls attention/mental speed was more affected among cardiac arrest patients, but results for memory and executive functioning were similar.CONCLUSIONS: -Cognitive function was comparable in survivors of out-of-hospital cardiac arrest when targeting a temperature of 33ºC and 36ºC. Cognitive impairment detected in cardiac arrest survivors was also common in matched STEMI-controls not having had a cardiac arrest. Clinical Trial Registration Information-ClinicalTrials.gov. Identifier: NCT01946932.

AB - BACKGROUND: -Target temperature management is recommended as a neuro-protective strategy after out-of-hospital cardiac arrest. Potential effects of different target temperatures on cognitive impairment commonly described in survivors are not sufficiently investigated. The primary aim of this study was to evaluate whether a target temperature of 33ºC compared to 36ºC was favourable for cognitive function, and secondary to describe cognitive impairment in cardiac arrest survivors in general.METHODS AND RESULTS: -Study-sites included 652 cardiac arrest survivors originally randomized and stratified for site to temperature control at 33ºC or 36ºC within the Target Temperature Management trial. Survival until 180 days after the arrest was 52% (33ºC n=178/328 36ºC n=164/324). Survivors were invited to a face-to-face follow-up and 287 cardiac arrest survivors (33ºC n=148/36ºC n=139) were assessed with tests for memory (Rivermead Behavioural Memory Test), executive functions (Frontal Assessment Battery) and attention/mental speed (Symbol Digit Modalities Test). A control-group of 119 matched patients hospitalized for acute ST-elevation myocardial infarction (STEMI) without cardiac arrest performed the same assessments. Half of the cardiac arrest survivors had cognitive impairment, which was mostly mild. Cognitive outcome did not differ (p >0.30) between the two temperature groups (33ºC/36ºC). Compared to STEMI-controls attention/mental speed was more affected among cardiac arrest patients, but results for memory and executive functioning were similar.CONCLUSIONS: -Cognitive function was comparable in survivors of out-of-hospital cardiac arrest when targeting a temperature of 33ºC and 36ºC. Cognitive impairment detected in cardiac arrest survivors was also common in matched STEMI-controls not having had a cardiac arrest. Clinical Trial Registration Information-ClinicalTrials.gov. Identifier: NCT01946932.

U2 - 10.1161/CIRCULATIONAHA.114.014414

DO - 10.1161/CIRCULATIONAHA.114.014414

M3 - Journal article

C2 - 25681466

VL - 131

SP - 1340

EP - 1349

JO - Circulation (Baltimore)

JF - Circulation (Baltimore)

SN - 0009-7322

IS - 15

ER -

Cognitive Function in Survivors of Out-of-Hospital Cardiac Arrest After Target Temperature Management at 33ºC Versus 36ºC

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