Of the 25 percent of people who survive in-hospital cardiac arrests and 12 percent of people who survive out-of-hospital cardiac arrests, many will unknowingly be discharged from the hospital with cognitive problems in their future. In a new study from the Baycrest Centre for Geriatric Care, scientists recommend that all cardiac arrest survivors be tested for neuropsychological problems before being discharged.
Even if they seem “neurologically intact” before being discharged, cardiac arrest survivors often develop memory and cognitive problems in the months or years following the event. "These people may go home and think they are neurologically fine, but then they realize things have changed and they may not be able to do their job, and it can be difficult for them to figure out where to seek help,” explained first author Dr. Vess Stamenova.
Cardiac arrest is an “electrical problem” in the heart, characterized by a sudden loss of a heartbeat, often a result of an irregular heartbeat, or an arrhythmia. Cardiac arrest can result in death in just a few minutes. Every minute after cardiac arrest occurs where the affected individual is not attended to is linked to a ten percent decrease in survival. Plus, as the current study points out, survivors of cardiac arrest are at risk of brain damage.
Researchers conducted a study with 18 individuals who had either a heart attack or brief cardiac arrest, giving them neuropsychological assessments and taking brain images. This study is the first to take brain images of short cardiac arrest survivors. Each study participant was evaluated between two and four years after their incident.
The study scientists found that some cardiac arrest survivors left the hospital seemingly fine, only to develop memory problems later. Specifically, researchers saw a 10-20 percent reduction in the size of the hippocampus, region of the brain responsible for keeping memories. This part of the brain is particularly sensitive to a lack of oxygen.
The solution, researchers conclude, is to develop comprehensive neuropsychology testing as a standard precaution for every cardiac arrest patient before they leave the hospital. This would allow medical professionals to diagnose any problems as soon as possible so the patient can receive appropriate and timely treatment.
"Identifying patients at risk will allow cardiac arrest survivors to have appropriate recommendations for rehabilitation before they are discharged," Stamenova said.
Overall, Stamenova and others involved in the study are focused on improving long-term quality of life for cardiac arrest survivors.
The present study was published in the journal Resuscitation.
Sources: American Heart Association, Baycrest Centre for Geriatric Care