Chronic memory impairment after cardiac arrest outside hospital

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Abstract
Objectives: To evaluate the nature, prevalence, and severity of chronic memory deficit in patients resuscitated after cardiac arrest outside hospital and to determine whether such deficits are related to duration of cardiac arrest. Design: Case-control study. Subjects: 35 survivors of cardiac arrest outside hospital and 35 controls matched for age and sex who had had acute myocardial infarction without cardiac arrest. Main outcome measures: Subjects assessed at least two months after index event for affective state (hospital anxiety and depression scale), premorbid intelligence (national adult reading test), short term recall (digit recall test), and episodic long term memory (Rivermead behavioural memory test). Results: Cases and controls showed no difference in short term recall. Cases scored lower on Rivermead test than controls (mean (SD) score out of 24 points: 17.4 (5.4) v 21.8 (2.0), PConclusions: Clinically important impairment of memory was common after cardiac arrest outside hospital. Improvement in response times of emergency services could reduce the severity of such deficits. With an increasing numbers of people expected to survive cardiac arrest outside hospital, rehabilitation of those with memory deficit merits specific attention. In this study of 35 such patients we found that over a third had important chronic deficits in long term memory, though orientation and short term memory were unimpaired Memory scores were inversely correlated with the duration of the cardiac arrest, suggesting that improvement of emergency services' response times might result in better cognitive outcomes Targeted rehabilitation strategies could train patients to make the best use of their remaining memory function Assessment of cognitive function is an important component of patients' man- agement after discharge from hospital