Long-term neuropsychological outcomes in children and adolescents after cardiac arrest

Intensive Care Med. 2015 Jun;41(6):1057-66. doi: 10.1007/s00134-015-3789-y. Epub 2015 Apr 18.

Abstract

Purpose: Research into neuropsychological functioning of survivors of cardiac arrest (CA) in childhood is scarce. We sought to assess long-term neuropsychological functioning in children and adolescents surviving CA.

Methods: Neuropsychological follow-up study involving all consecutive children surviving CA between January 2002 and December 2011. Intelligence (IQ), language, attention, memory, visual-spatial, and executive functioning were assessed with internationally validated, neuropsychological tests and questionnaires. Scores were compared with Dutch normative data.

Results: Of 107 eligible children, 47 who visited the outpatient clinic (median follow-up interval: 5.6 years) were analyzed. Fifty-five percent had an in-hospital CA, 86% a non-shockable rhythm, and 49% a respiratory-related etiology. CA survivors scored significantly worse on full-scale IQ (mean = 87.3), verbal IQ (mean = 92.7), performance IQ (mean = 85.6), verbal comprehension index (mean = 93.4), perceptual organization index (mean = 83.8), and processing speed index (mean = 91.1), than the norm population (mean IQ = 100). On neuropsychological tests, compared with norms, respectively adjusted for IQ, significantly worse scores were found on visual memory, significantly better on verbal memory (recognition), and comparable outcomes on visual-motor integration, attention, other measures of verbal memory, and executive functioning. On questionnaires, parents reported better executive functioning than the norm, but teachers reported more problems in planning/organizing skills.

Conclusions: Long-term neuropsychological assessment of CA survivors showed significant weaknesses, but also relatively intact functioning. As deficits in IQ, memory and executive functioning have significant impact on the child, long-term follow-up and neuropsychological support of CA survivors is warranted.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cognition / physiology
  • Executive Function / physiology
  • Female
  • Follow-Up Studies
  • Health Surveys
  • Heart Arrest / etiology
  • Heart Arrest / psychology*
  • Humans
  • Infant
  • Infant, Newborn
  • Intelligence / physiology
  • Male
  • Nervous System Diseases / diagnosis*
  • Neuropsychological Tests*
  • Psychophysiologic Disorders / diagnosis*
  • Survivors*
  • Time Factors