How Do You Feel? Subjective Perception of Recovery as a Reliable Surrogate of Cognitive and Functional Outcome in Cardiac Arrest Survivors

Abstract

Long-term subjective and objective outcome appears good in the majority of cardiac arrest survivors. Specific functional and cognitive impairments were found in patients reporting unsatisfactory recovery. Subjective recovery was strongly correlated with objective assessment.

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)

“…that those with excellent recovery may be more likely to say yes to being part of the study, skewing the data in a positive way. These tendencies have been observed in other studies [10,12,17]. On the other hand, we have information from the main TTM2-trial on the patients declining to participate in this sub-study, facilitating analyses of missing data.…”

“…Striving for high specificity, especially in the neuropsychological test battery, we adjust for level of education in our main outcome measures. When comparing the results on the neurocognitive screening with the detailed neuropsychological test battery, the chosen cut-score of z ≤ − 1.65 was inspired by a similar OHCA study [12]. We have refrained from pre-specified comparisons of the neuropsychological function between the 33°C and normothermia treatment arms.…”

“…These cognitive domains are often impaired post-arrest, but also the most commonly assessed [11]. Others have reported that language and visual/constructive functions may be affected as well [12][13][14]. Brain damage is often diffuse with multiple atrophic areas due to transient global cerebral ischemia [15,16].…”

The impact of psychological distress on long-term recovery perceptions in survivors of cardiac arrest

“…medication nonadherence, lifestyle, and rehabilitation noncompliance) [35,38,39], which can ultimately lead to a worse perceived and actual recovery. Due to low rates of depression in Juan et al [9], their study could not assess the effect of depressive symptoms on recovery perceptions. Overall, our findings support the notion that, when present, depressive symptomatology holds greater importance in cardiac patients' perceived recovery compared to other recovery domains.…”

“…For example, Steinbusch et al [8] found that post-arrest patients' perceived cognitive impairments were not indicative of their actual cognitive impairments at 3-and 12-month follow-ups. On the contrary, Juan et al [9] found post-arrest patients' cognitive impairments, but not depressive symptoms, to be strongly correlated with negative perceptions of recovery at 6-months; however, the incidence of depression in that cohort was low (6%), and the relatively small sample size (n=50) precluded definitive conclusions. In samples of stroke survivors and older adults, subjects' cognitive complaints were correlated with emotional well-being and depressive symptoms, rather than objective measures of cognitive impairment [10,11].…”