Neuropsychological outcome after cardiac arrest: a prospective case control sub-study of the Targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest trial (TTM2)

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  • Erik Blennow Nordström, Skåne University Hospital, Department of Clinical Sciences Lund, Surgery, Lund University, Lund, Sweden.
  • ,
  • Gisela Lilja, Skåne University Hospital, Department of Clinical Sciences Lund, Surgery, Lund University, Lund, Sweden.
  • ,
  • Susanna Vestberg, Skåne University Hospital, Department of Clinical Sciences Lund, Surgery, Lund University, Lund, Sweden.
  • ,
  • Susann Ullén, Skane University Hospital and Lund University, Lund, Sweden.
  • ,
  • Hans Friberg, Skåne University Hospital, Department of Clinical Sciences Lund, Surgery, Lund University, Lund, Sweden.
  • ,
  • Niklas Nielsen, Skåne University Hospital, Department of Clinical Sciences Lund, Surgery, Lund University, Lund, Sweden.
  • ,
  • Katarina Heimburg, Skåne University Hospital, Department of Clinical Sciences Lund, Surgery, Lund University, Lund, Sweden.
  • ,
  • Lars Evald
  • Marco Mion, Basildon and Thurrock University Hospitals
  • ,
  • Magnus Segerström, Sahlgrenska University Hospital, University of Gothenborg
  • ,
  • Anders M Grejs
  • Thomas Keeble, Basildon and Thurrock University Hospitals
  • ,
  • Hans Kirkegaard
  • Hanna Ljung, Skåne University Hospital, Department of Clinical Sciences Lund, Surgery, Lund University, Lund, Sweden.
  • ,
  • Sofia Rose, Cardiff and Vale University Health Board
  • ,
  • Matthew P Wise, Dept. of Psychological Medicine, School of Medicine, Cardiff University, Cardiff CF10 3XQ, UK
  • ,
  • Christian Rylander, Univ Gothenburg, University of Gothenburg, Gothenburg Global Biodivers Ctr
  • ,
  • Johan Undén, Skåne University Hospital, Department of Clinical Sciences Lund, Surgery, Lund University, Lund, Sweden.
  • ,
  • Tobias Cronberg, Skåne University Hospital, Department of Clinical Sciences Lund, Surgery, Lund University, Lund, Sweden.

BACKGROUND: This study is designed to provide detailed knowledge on cognitive impairment after out-of-hospital cardiac arrest (OHCA) and its relation to associated factors, and to validate the neurocognitive screening of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest trial (TTM2-trial), assessing effectiveness of targeted temperature management after OHCA.

METHODS: This longitudinal multi-center clinical study is a sub-study of the TTM2-trial, in which a comprehensive neuropsychological examination is performed in addition to the main TTM2-trial neurocognitive screening. Approximately 7 and 24 months after OHCA, survivors at selected study sites are invited to a standardized assessment, including performance-based tests of cognition and questionnaires of emotional problems, fatigue, executive function and insomnia. At 1:1 ratio, a matched control group from a cohort of acute myocardial infarction (MI) patients is recruited to perform the same assessment. We aim to include 100 patients per group. Potential differences between the OHCA patients and the MI controls at 7 and 24 months will be analyzed with a linear regression, using composite z-scores per cognitive domain (verbal, visual/constructive, working memory, episodic memory, processing speed, executive functions) as primary outcome measures. Results from OHCA survivors on the main TTM2-trial neurocognitive screening battery will be compared with neuropsychological test results at 7 months, using sensitivity and specificity analyses.

DISCUSSION: In this study we collect detailed information on cognitive impairment after OHCA and compare this to a control group of patients with acute MI. The validation of the TTM2 neurocognitive screening battery could justify its inclusion in routine follow-up. Our results may have a potential to impact on the design of future follow-up strategies and interventions after OHCA.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT03543371 . Registered 1 June 2018.

OriginalsprogEngelsk
Artikelnummer439
TidsskriftBMC Cardiovascular Disorders
Vol/bind20
Nummer1
Sider (fra-til)11
ISSN1471-2261
DOI
StatusUdgivet - okt. 2020

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