Aim

To investigate longitudinal functional and neuropsychological outcomes 3–6 and 24 months after paediatric out-of-hospital cardiac arrest (OHCA). Further, to explore the association between paediatric cerebral performance category (PCPC) and intelligence.

Methods

Prospective longitudinal single center study including children (0–17 years) with OHCA, admitted to the PICU of a tertiary care hospital between 2012 and 2017. Survivors were assessed during an outpatient multidisciplinary follow-up program 3–6 and 24 months post-OHCA. Functional and neuropsychological outcomes were assessed through interviews, neurological exam, and validated neuropsychological testing.

Results

The total eligible cohort consisted of 49 paediatric OHCA survivors. The most common cause of OHCA was arrhythmia (33%). Median age at time of OHCA was 48 months, 67% were males. At 3–6 and 24 months post-OHCA, respectively 74 and 73% had a good PCPC score, defined as 1–2. Compared with normative data, OHCA children obtained worse sustained attention and processing speed scores 3–6 (n = 26) and 24 (n = 27) months post-OHCA. At 24 months, they also obtained worse intelligence, selective attention and cognitive flexibility scores. In children tested at both time-points (n = 19), no significant changes in neuropsychological outcomes were found over time. Intelligence scores did not correlate with PCPC.

Conclusion

Although paediatric OHCA survivors had a good PCPC score 3–6 and 24 months post-OHCA, they obtained worse scores on important neuropsychological domains such as intelligence and executive functioning (attention and cognitive flexibility). Follow-up should continue over a longer life span in order to fully understand the long-term impact of OHCA in childhood.

中文翻译：

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儿童心脏骤停后两年神经心理结局的纵向评估

目的

调查儿科院外心脏骤停 (OHCA) 后 3-6 个月和 24 个月的纵向功能和神经心理学结果。进一步探讨小儿脑功能分类（PCPC）与智力的关系。

方法

前瞻性纵向单中心研究，包括 2012 年至 2017 年期间入住三级护理医院 PICU 的 OHCA 儿童（0-17 岁）。在 OHCA 后 3-6 个月和 24 个月的门诊多学科随访计划中对幸存者进行评估. 通过访谈、神经学检查和经过验证的神经心理学测试来评估功能和神经心理学结果。

结果

全部符合条件的队列包括 49 名儿科 OHCA 幸存者。OHCA 的最常见原因是心律失常 (33%)。OHCA 时的中位年龄为 48 个月，67% 为男性。在 OHCA 后 3-6 个月和 24 个月，分别有 74% 和 73% 的人获得了良好的 PCPC 评分，定义为 1-2。与正常数据相比，OHCA 儿童在 OHCA 后 3-6 ( n  = 26) 和 24 ( n  = 27) 个月获得更差的持续注意力和处理速度得分。在 24 个月时，他们的智力、选择性注意力和认知灵活性得分也较差。在两个时间点 ( n  = 19)测试的儿童中，未发现神经心理学结果随时间发生显着变化。智力分数与 PCPC 无关。

结论

尽管儿科 OHCA 幸存者在 OHCA 后 3-6 个月和 24 个月的 PCPC 评分良好，但他们在重要的神经心理学领域如智力和执行功能（注意力和认知灵活性）方面的得分较差。随访应持续更长的生命周期，以充分了解 OHCA 对儿童期的长期影响。