Skip to main content
PMC home page
The BMJ logoLink to The BMJ
. 1996 Jul 20;313(7050):143–146. doi: 10.1136/bmj.313.7050.143

Chronic memory impairment after cardiac arrest outside hospital.

N R Grubb 1, R O'Carroll 1, S M Cobbe 1, J Sirel 1, K A Fox 1
PMCID: PMC2351568  PMID: 8688775

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), P < 0.001), particularly in subtests relating to verbal and spatial memory. Moderate or severe impairment was found in 37% of cases and in no controls. Severity of impairment of memory correlated significantly with measures of duration of cardiac arrest. This deficit was not significantly associated with subjects' age, interval from index event to assessment, occupation, measures of comorbidity, social deprivation, anxiety or depression scores, or estimated premorbid intelligence. CONCLUSIONS--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.

Full text

PDF
143

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bass E. Cardiopulmonary arrest. Pathophysiology and neurologic complications. Ann Intern Med. 1985 Dec;103(6 ):920–927. doi: 10.7326/0003-4819-103-6-920. [DOI] [PubMed] [Google Scholar]
  2. Beuret P., Feihl F., Vogt P., Perret A., Romand J. A., Perret C. Cardiac arrest: prognostic factors and outcome at one year. Resuscitation. 1993 Apr;25(2):171–179. doi: 10.1016/0300-9572(93)90093-6. [DOI] [PubMed] [Google Scholar]
  3. Brooks D. N. Memory and head injury. J Nerv Ment Dis. 1972 Nov;155(5):350–355. doi: 10.1097/00005053-197211000-00007. [DOI] [PubMed] [Google Scholar]
  4. Cobbe S. M., Redmond M. J., Watson J. M., Hollingworth J., Carrington D. J. "Heartstart Scotland"--initial experience of a national scheme for out of hospital defibrillation. BMJ. 1991 Jun 22;302(6791):1517–1520. doi: 10.1136/bmj.302.6791.1517. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cummins R. O., Ornato J. P., Thies W. H., Pepe P. E. Improving survival from sudden cardiac arrest: the "chain of survival" concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. Circulation. 1991 May;83(5):1832–1847. doi: 10.1161/01.cir.83.5.1832. [DOI] [PubMed] [Google Scholar]
  6. Dougherty C. M. Longitudinal recovery following sudden cardiac arrest and internal cardioverter defibrillator implantation: survivors and their families. Am J Crit Care. 1994 Mar;3(2):145–154. [PubMed] [Google Scholar]
  7. Fricchione G. L., Olson L. C., Vlay S. C. Psychiatric syndromes in patients with the automatic internal cardioverter defibrillator: anxiety, psychological dependence, abuse, and withdrawal. Am Heart J. 1989 Jun;117(6):1411–1414. doi: 10.1016/0002-8703(89)90457-2. [DOI] [PubMed] [Google Scholar]
  8. Grubb N. R., Elton R. A., Fox K. A. In-hospital mortality after out-of-hospital cardiac arrest. Lancet. 1995 Aug 12;346(8972):417–421. doi: 10.1016/s0140-6736(95)92784-0. [DOI] [PubMed] [Google Scholar]
  9. Guly U. M., Mitchell R. G., Cook R., Steedman D. J., Robertson C. E. Paramedics and technicians are equally successful at managing cardiac arrest outside hospital. BMJ. 1995 Apr 29;310(6987):1091–1094. doi: 10.1136/bmj.310.6987.1091. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hamer D. W., Gordon M. W., Cusack S., Robertson C. E. Survival from cardiac arrest in an accident and emergency department: the impact of out of hospital advisory defibrillation. Resuscitation. 1993 Aug;26(1):31–37. doi: 10.1016/0300-9572(93)90160-r. [DOI] [PubMed] [Google Scholar]
  11. Herlitz J., Ekström L., Wennerblom B., Axelsson A., Bång A., Holmberg S. Survival in patients found to have ventricular fibrillation after cardiac arrest witnessed outside hospital. Eur Heart J. 1994 Dec;15(12):1628–1633. doi: 10.1093/oxfordjournals.eurheartj.a060445. [DOI] [PubMed] [Google Scholar]
  12. Hillis M., Sinclair D., Butler G., Cain E. Prehospital cardiac arrest survival and neurologic recovery. J Emerg Med. 1993 May-Jun;11(3):245–252. doi: 10.1016/0736-4679(93)90041-5. [DOI] [PubMed] [Google Scholar]
  13. Kiowski W., Linder L., Kleinbloesem C., van Brummelen P., Bühler F. R. Blood pressure control by the renin-angiotensin system in normotensive subjects. Assessment by angiotensin converting enzyme and renin inhibition. Circulation. 1992 Jan;85(1):1–8. doi: 10.1161/01.cir.85.1.1. [DOI] [PubMed] [Google Scholar]
  14. Nelson H. E., O'Connell A. Dementia: the estimation of premorbid intelligence levels using the New Adult Reading Test. Cortex. 1978 Jun;14(2):234–244. doi: 10.1016/s0010-9452(78)80049-5. [DOI] [PubMed] [Google Scholar]
  15. Powell J., Pickering A., Wyke M., Goggin T. The effects of anti-hypertensive medication on learning and memory. Br J Clin Pharmacol. 1993 Feb;35(2):105–113. doi: 10.1111/j.1365-2125.1993.tb05675.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Sedgwick M. L., Dalziel K., Watson J., Carrington D. J., Cobbe S. M. Performance of an established system of first responder out-of-hospital defibrillation. The results of the second year of the Heartstart Scotland Project in the 'Utstein Style'. Resuscitation. 1993 Aug;26(1):75–88. doi: 10.1016/0300-9572(93)90166-n. [DOI] [PubMed] [Google Scholar]
  17. Squire L. R., Amaral D. G., Press G. A. Magnetic resonance imaging of the hippocampal formation and mammillary nuclei distinguish medial temporal lobe and diencephalic amnesia. J Neurosci. 1990 Sep;10(9):3106–3117. doi: 10.1523/JNEUROSCI.10-09-03106.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Torp-Pedersen C., Birk Madsen E., Pedersen A. Sudden cardiac arrest outside the hospital--value of defibrillators in ambulances. Resuscitation. 1991 Apr;21(2-3):283–288. doi: 10.1016/0300-9572(91)90053-2. [DOI] [PubMed] [Google Scholar]
  19. Townes B. D., Bashein G., Hornbein T. F., Coppel D. B., Goldstein D. E., Davis K. B., Nessly M. L., Bledsoe S. W., Veith R. C., Ivey T. D. Neurobehavioral outcomes in cardiac operations. A prospective controlled study. J Thorac Cardiovasc Surg. 1989 Nov;98(5 Pt 1):774–782. [PubMed] [Google Scholar]
  20. Weaver W. D., Cobb L. A., Hallstrom A. P., Fahrenbruch C., Copass M. K., Ray R. Factors influencing survival after out-of-hospital cardiac arrest. J Am Coll Cardiol. 1986 Apr;7(4):752–757. doi: 10.1016/s0735-1097(86)80332-1. [DOI] [PubMed] [Google Scholar]
  21. Wilson B., Cockburn J., Baddeley A., Hiorns R. The development and validation of a test battery for detecting and monitoring everyday memory problems. J Clin Exp Neuropsychol. 1989 Dec;11(6):855–870. doi: 10.1080/01688638908400940. [DOI] [PubMed] [Google Scholar]
  22. Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES