Objectives

The primary aim of this review was to investigate neurocognitive outcomes following out-of-hospital cardiac arrest (OHCA). Specifically, the focus was on identifying the different neurocognitive domains that are assessed, the measures used, and the level of, and criteria for, impairment.

Design and review methods: A systematic review of the literature from 2006 to 2021 was completed using Medline, Cinahl and Psychinfo. Criteria for inclusion were studies with participants over the age of 18, OHCA and at least one neurocognitive function measure. Qualitative and case studies were excluded. Reviewers assessed criteria and risk of bias using a modified version of Downs and Black.

Results

Forty-three studies were identified. Most studies had a low risk of bias (n=31) or moderate risk of bias (n=11) and one had a high risk; however, only six reported effect sizes or power analyses. Multiple measures of neurocognitive outcomes were used (>50) and level of impairment criteria varied considerably. Memory impairments were frequently found and were also more likely to be impaired followed by executive function and processing speed.

Discussion

This review highlights the heterogeneity of measures and approaches used to assess neurocognitive outcomes following OHCA as well as the need to improve risk of bias concerning generalizability. Improved understanding of the approaches used for assessment and the subsequent findings will facilitate a standardized evaluation of neurocognitive outcomes following OHCA.

中文翻译：

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院外心脏骤停后的神经认知功能：系统评价

目标

本综述的主要目的是调查院外心脏骤停 (OHCA) 后的神经认知结果。具体来说，重点是确定评估的不同神经认知领域、使用的测量方法以及损伤的程度和标准。

设计和审查方法：使用 Medline、Cinahl 和 Psychinfo 完成了对 2006 年至 2021 年文献的系统审查。纳入标准是对 18 岁以上参与者、OHCA 和至少一项神经认知功能测量的研究。定性和案例研究被排除在外。审稿人使用修改版的 Downs and Black 评估标准和偏倚风险。

结果

确定了 43 项研究。大多数研究具有低偏倚风险（n=31）或中度偏倚风险（n=11），一项研究具有高风险；然而，只有六个报告了效果大小或功效分析。使用了多种神经认知结果测量方法（>50），损伤标准水平差异很大。记忆障碍经常被发现，也更容易受到损害，其次是执行功能和处理速度。

讨论

这篇综述强调了用于评估 OHCA 后神经认知结果的措施和方法的异质性，以及提高关于普遍性的偏倚风险的必要性。更好地理解用于评估的方法和随后的发现将有助于对 OHCA 后的神经认知结果进行标准化评估。