Predicting Long-Term Cognitive Impairments in Survivors after Cardiac Arrest: A Systematic Review.
Astrid Glimmerveen, Marlous Verhulst, Jeanine Verbunt and 2 others
PMID 36714933WHAT IT FOUND
Longer coma duration and higher day-3 S-100B levels predicted worse memory and executive function at 3 to 6 months.
A bedside cognitive screen predicted individual impairment with 90% sensitivity and 82% specificity, but this finding rests on one small sample of 26 patients.
Key findings
01Longer coma duration predicted poorer cognitive composite scores and worse performance in executive functions, attention, memory, visuospatial ability and fine motor functioning at 3 months.
02Elevated day-3 S-100B blood levels predicted poorer memory and executive function performance at 6 months.
03A bedside cognitive screening score of 94.5 or lower predicted cognitive impairment at 6 months with 90% sensitivity and 82% specificity, though this was shown in a small sample of 26 and not validated separately.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The evidence base is very small, with only five studies included. Patient samples in the included studies likely overlapped, reducing the effective number of unique participants. The promising bedside screening tool (BNTB) was validated in only one study with 26 participants and has not been tested in a separate cohort. No studies were found that evaluated EEG or MRI measures for predicting cognitive outcomes. Follow-up times varied between 3 and 6 months, and different studies used different definitions for what constituted cognitive impairment.
Declared interests
Not reported in the provided text.
The easy way to misread this
Do not adopt the BNTB screening tool or its 94.5 cut-off score for clinical practice yet. This predictive accuracy was demonstrated in a single small study of 26 patients and has not been validated in other groups.