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Flickinger KL, Jaramillo S, Repine MJ, et al. One-year outcomes in individual domains of the cerebral performance category extended. Resusc Plus. 2021;8:100184doi: 10.1016/j.resplu.2021.100184.
Flickinger, K. L., Jaramillo, S., Repine, M. J., Koller, A. C., Holm, M., Skidmore, E., Callaway, C., & Rittenberger, J. C. (2021). One-year outcomes in individual domains of the cerebral performance category extended. Resuscitation plus, 8100184. https://doi.org/10.1016/j.resplu.2021.100184
Flickinger, Katharyn L, et al. "One-year outcomes in individual domains of the cerebral performance category extended." Resuscitation plus vol. 8 (2021): 100184. doi: https://doi.org/10.1016/j.resplu.2021.100184
Flickinger KL, Jaramillo S, Repine MJ, Koller AC, Holm M, Skidmore E, Callaway C, Rittenberger JC. One-year outcomes in individual domains of the cerebral performance category extended. Resusc Plus. 2021 Dec 06;8:100184. doi: 10.1016/j.resplu.2021.100184. eCollection 2021 Dec. PMID: 34934994; PMCID: PMC8661046.
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Resusc Plus. 2021 Dec 06;8:100184. doi: 10.1016/j.resplu.2021.100184. eCollection 2021 Dec.

One-year outcomes in individual domains of the cerebral performance category extended.

Resuscitation plus

Katharyn L Flickinger, Stephany Jaramillo, Melissa J Repine, Allison C Koller, Margo Holm, Elizabeth Skidmore, Clif Callaway, Jon C Rittenberger

Affiliations

  1. Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
  2. Department of Occupational Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, PA, USA.
  3. Department of Emergency Medicine, Guthrie Robert Packer Hospital, Sayre, PA, USA.

PMID: 34934994 PMCID: PMC8661046 DOI: 10.1016/j.resplu.2021.100184

Abstract

BACKGROUND: Physical and cognitive impairments are common after cardiac arrest, and recovery varies. This study assessed recovery of individual domains of the Cerebral Performance Category- Extended (CPC-E) 1-year after cardiac arrest. We hypothesized patients would have recovery in all CPC-E domains 1-year after the index cardiac arrest.

METHODS: Prospective cohort study of cardiac arrest survivors evaluating outcome measures mRS, CPC, and CPC-E. Outcomes were assessed at discharge, 3-months, 6-months, and 1-year. We defined recovery of a CPC-E domain when >90% of patients had scores of 1-2 in that domain.

RESULTS: Of 156 patients discharged, 57 completed the CPC-E at discharge, and were included in the analysis. 37 patients had follow-up at 3-months, and 23 patients had follow-up at 6 and 12 months. Only 16 patients had assessments at all four timepoints. Domains of alertness (N = 56, 98%) logical thinking (N = 56; 98%), and attention (N = 55; 96%) recovered by hospital discharge. BADL (N = 34; 92%) and motor skills (N = 36; 97%) recovered by 3-months. Most patients (N = 20; 87%) experienced slight-to-no disability or symptoms (mRS 0-2/CPC 1-2) at 1-year follow up. CPC-E domains of short term memory (78%), mood (87%), fatigue (22%), complex ADL (78%), and return to work (65%) did not recover by 1-year.

CONCLUSIONS: CPC-E domains of alertness, logical thinking, and attention recover rapidly, while domains of short term memory, mood, fatigue, complex ADL and return to work remain chronically impaired 1-year after cardiac arrest. These deficits are not detected by mRS and CPC. Interventions to improve recovery in these domains are needed.

© 2021 The Author(s).

Keywords: BADL, Basic Activities of Daily Living; CA, Cardiac Arrest; CADL, Complex Activities of Daily Living; CPC, Cerebral Performance Category; CPC-E, Cerebral Performance Category Extended; Cardiac arrest; Outcome; PCAC, Post Cardiac Arrest Category; Recovery; Rehabilitation; mRS, Modified Rankin Scale

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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