The PhD thesis of Eirik Alnes Buanes shows that almost 30 % of cardiac arrest survivors have cognitive impairment four years later, that therapeutic hypothermia can increase survival, and that as many survive out-of-hospital cardiac arrest as in-hospital cardiac arrest.
- Survival to hospital discharge was just above 16 % for both in-hospital and out-of-hospital cardiac arrest patients.
- Cognitive impairment affected more than one quarter of the patients four years after cardiac arrest. Short-term memory was especially impaired.
- Treatment including therapeutic hypothermia to 33 °C seems to increase survival for unresponsive cardiac arrest patients.
Thesis: Cardiac Arrest in a Community: Epidemiology, Treatment, and Outcome
Candidate: Eirik Alnes Buanes
Time: September 1, 2017 at 12:15
Place: Haukeland University Hospital, The Children and Youth Hospital: Auditorium 1
Link to university website (in Norwegian)
(1) 16.2 % of in-hospital cardiac arrest patients survived to hospital discharge, compared to 16.8 % of out-of-hospital cardiac arrest patients.
The cohort consisted of 380 patients treated at Haukeland University Hospital from December 2008 to December 2009. Not surprisingly, the in-hospital group was older and more often suffered from witnessed cardiac arrest and was given cardiopulmonary resuscitation and direct current shock from a professional first rescuer.
(2) Among 30 cardiac arrest survivors with good neurologic outcome at discharge – according to the cerebral performance categories – 29 % were cognitively impaired four years later. Cognition was assessed by a touch-screen, computer-based cognitive function assessment tool, and compared with population norms.
(3) Cardiac arrest patients given intensive care treatment including targeted temperature management at 33 °C survived for a mean of 57 days longer during the first year than propensity score matched patients not treated with therapeutic hypothermia.
186 patients treated between 2003 and 2008 were included in the analysis. Causality can not be established from observational studies. However, given the propensity score model used, the researchers argue that targeted temperature management likely increases survival for unresponsive patients following out-of-hospital cardiac arrest.
(1) Buanes, E. A., & Heltne, J. K. (2014). Comparison of in‐hospital and out‐of‐hospital cardiac arrest outcomes in a Scandinavian community. Acta anaesthesiologica Scandinavica, 58(3), 316-322.
(2) Buanes, E. A., Gramstad, A., Søvig, K. K., Hufthammer, K. O., Flaatten, H., Husby, T., Langørgen, J., & Heltne, J. K. (2015). Cognitive function and health-related quality of life four years after cardiac arrest. Resuscitation, 89, 13-18.
(3) Buanes, E. A., Hufthammer, K. O., Langørgen, J., Guttormsen, A. B., & Heltne, J. K. (2017). Targeted temperature management in cardiac arrest: survival evaluated by propensity score matching. Scandinavian journal of trauma, resuscitation and emergency medicine, 25(1), 31.