Up to half of Out of Hospital Cardiac Arrest (OHCA) survivors experience long-term cognitive impairments associated with acute hypoxic brain injury, including deficits in memory, executive function and/or processing speed (Zook et al. 2022). Clinical guidelines recommend clinicians be are aware of potential difficulties with cognitive function and screen accordingly (ANZCOR, 2016). Despite the well-documented relationship between cognition and communication, there is an absence of literature on the assessment and management for cognitive-communication disorders in this population.

Objectives
1. Describe cognitive-communication functioning of inpatients after OHCA
2. Identify the need for assessment and management; and
3. Establish a speech pathology referral criteria.

Method
A prospective cohort study was conducted of inpatients admitted after an OHCA at a specialised tertiary cardiac care facility. Patient demographics including age, gender, previous medical history and social history were documented. Details of the arrest, including downtime prior to return of spontaneous circulation (ROSC) and neurological imaging were collected. Cognitive-communication functioning was assessed using Sheffield Language Screener and Mini Inventory of Right Brain Injury (MIRBI-2) which guided the impression of Australian Therapy Outcome Measure Scale (AusTOMs)and family member self-report of acute changes in cognitive-communication function.

Results
Preliminary data indicates that 70% of OHCA survivors (n=22) present with a cognitive-communication impairment. There is a relationship between downtime and cognitive-communication presentation. . Patients identified as having a ‘moderate cognitive-communication impairment’ as per AusTOMs had an average of 26 minutes downtime, whilst patients identified as having a ‘mild cognitive-communication impairment’ had an average of 11 minutes downtime. Data further suggests that NOK impression of change in cognition can predict the presence of cognitive-communication impairment.

Conclusions
The majority of OHCA’s in this study have a cognitive-communication disorder identified through standardised assessment and collateral from family members. The period of downtime may be related to the severity of cognitive-communication disorder.

Zook, N., Voss, S., Blennow Nordström, E., Brett, S. J., Jenkinson, E., Shaw, P., White, P., & Benger, J. (2022). Neurocognitive function following out-of-hospital cardiac arrest: A systematic review. Resuscitation, 170, 238–246. https://doi.org/10.1016/j.resuscitation.2021.10.005

Guideline 11.7 Post-resuscitation Therapy in Adult Advanced Life Support. (n.d.). https://www.anzcor.org/assets/anzcor-guidelines/guideline-11-7-post-resuscitation-therapy-in-adult-advanced-life-support-250.pdf