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Joshi VL, Borregaard B, Mikkelsen TB, Tang LH, Nordström EB, Bruvik SM, Wieghorst A, Zwisler AD, Wagner MK. Observer-reported cognitive decline in out-of-hospital cardiac arrest survivors and its association with long-term survivor and relative outcomes. Resuscitation 2024; 197:110162. [PMID: 38452993 DOI: 10.1016/j.resuscitation.2024.110162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/04/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
AIM Long-term cognitive decline after out-of-hospital cardiac arrest (OHCA) is still poorly understood. This study describes long-term observer-reported cognitive decline among Danish OHCA survivors, including differences in years since the event, and investigates characteristics and self-reported outcomes associated with observer-reported cognitive decline. METHODS Adults who survived an OHCA from 2016 to 2019, and their relatives, completed the national DANish Cardiac Arrest Survivorship survey. Relatives completed the Informant Questionnaire on Cognitive Decline in the Elderly, Cardiac Arrest version (IQCODE-CA), the Hospital Anxiety and Depression Scale (HADS) and the World Health Organisation-Five Well-being index; and survivors completed the Two Simple Questions (everyday activities and mental recovery), the Modified Fatigue Impact Scale, HADS, and the Short World Health Organisation Disability Assessment Schedule 2.0. Potential associations between survivor characteristics and the IQCODE-CA were investigated using a multivariable logistic regression model. Self-reported outcomes among survivors and relatives, and the association with IQCODE-CA scores were investigated using separate logistic regression models. RESULTS Total median IQCODE-CA score was 3.04 (IQR: 3.00-3.27), with 47% having possible cognitive decline (score ≥ 3.04), consistent across time groups. Increasing age (OR 0.98, 95% CI: 0.97-0.99) and worse self-reported mental and physical outcomes for survivors and relatives, except 'everyday activities' were significantly associated with possible cognitive decline among survivors. CONCLUSIONS Nearly half of OHCA survivors may suffer long-term cognitive decline. Worse self-reported mental and physical outcomes among survivors and their relatives are associated with potential cognitive decline emphasising the need for post-OHCA care to include systematic neurocognitive assessment, tailored support and effective rehabilitation.
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Affiliation(s)
- Vicky L Joshi
- Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark.
| | - Britt Borregaard
- Department of Clinical Research, University of Southern Denmark Odense, Denmark; Department of Cardiology, Odense University Hospital, Odense, Denmark; Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
| | - Tina Broby Mikkelsen
- Department of Clinical Research, University of Southern Denmark Odense, Denmark; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Lars H Tang
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals & The Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Erik Blennow Nordström
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics), Skåne University Hospital, Sweden
| | | | - Anders Wieghorst
- Department of Clinical Research, University of Southern Denmark Odense, Denmark; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark; Department of Psychology, University of Southern Denmark, Odense, Denmark; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ann-Dorthe Zwisler
- Department of Clinical Research, University of Southern Denmark Odense, Denmark; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Mette Kirstine Wagner
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Wagner MK, Christensen J, Christensen KA, Dichman C, Gottlieb R, Kolster I, Hansen CM, Hoff H, Hassager C, Folke F, Winkel BG. A multidisciplinary guideline-based approach to improving the sudden cardiac arrest care pathway: The Copenhagen framework. Resusc Plus 2024; 17:100546. [PMID: 38260118 PMCID: PMC10801323 DOI: 10.1016/j.resplu.2023.100546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
Abstract
Although recommended in the European Resuscitation Council (ERC) and European Society of Intensive Care Medicine (ESICM) Guidelines, a framework for delivering post-cardiac arrest care in a systematic manner in dedicated high-volume cardiac arrest centers is lacking in the existing literature. To our knowledge, the Copenhagen Framework is the only established framework of its kind. The framework comprises management of out-of-hospital cardiac arrest (OHCA) survivors, and follow-up, and rehabilitation. The framework also incorporates research projects on cardiac arrest survivors and their close family members. The overall aim of this paper is to describe a framework made in order to bridge the gaps between international recommendations and delivering high-quality post-resuscitation clinical care, improving the continuity of care for OHCA survivors, access to post-CA rehabilitation, a seamless transition to everyday life, and ultimately patient outcomes in the future.
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Affiliation(s)
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kate Allen Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Camilla Dichman
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Rikke Gottlieb
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ida Kolster
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Carolina Malta Hansen
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
- Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
- Copenhagen Emergency Medical Services, Copenhagen University, Ballerup, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Helle Hoff
- Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
| | - Christian Hassager
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Fredrik Folke
- Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
- Copenhagen Emergency Medical Services, Copenhagen University, Ballerup, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Bo Gregers Winkel
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
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3
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van Til JA, Hemels MEW, Hofmeijer J. Cognitive screening and rehabilitation after cardiac arrest: only a few hurdles to take. Neth Heart J 2024; 32:63-66. [PMID: 38085507 PMCID: PMC10781901 DOI: 10.1007/s12471-023-01838-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 01/11/2024] Open
Abstract
Dutch and European guidelines recommend systematic screening for cognitive and emotional impairments in cardiac arrest survivors. We aimed to clarify opinions on cognitive screening and rehabilitation, identify barriers and facilitators for implementation in the Netherlands, and arrive at recommendations in this field. We conducted 22 semi-structured interviews with various stakeholders using the Tailored Implementation in Chronic Diseases checklist. There is broad-based acknowledgement of the relevance of cognitive impairment and a positive attitude regarding early cognitive screening among health professionals and patients. Barriers to implementation include a lack of practical recommendations on how, where and when to screen, insufficient knowledge of cognitive consequences of cardiac arrest, insufficient collaboration and knowledge sharing among different specialties within hospitals, insufficient resources, and insufficient evidence of the effectiveness of screening and therapy to justify financial compensation. Most of the identified barriers to implementation are solvable: national guidelines need practical recommendations and knowledge gaps among healthcare workers can be bridged by in-hospital collaboration. Fulfilling these requirements should be sufficient for the implementation of simple screening and tailored advice. More extensive cognitive rehabilitation therapy needs stronger evidence of efficacy in order to warrant stronger guideline recommendations and financial reimbursement.
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Affiliation(s)
- Janine A van Til
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
| | - Martin E W Hemels
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jeannette Hofmeijer
- Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
- Department of Clinical Neurophysiology, Technical Medical Centre, University of Twente, Enschede, The Netherlands
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4
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Hellström A, Bremer A, Gunnarsson L, Hjelm C. Sleep in cardiac arrest survivors. Nurs Crit Care 2023; 28:870-877. [PMID: 36168674 PMCID: PMC10947339 DOI: 10.1111/nicc.12843] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/16/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Insomnia, sleep apnoea and sleep loss are risk factors for the development of cardiovascular diseases. Most research on sleep disturbances includes patients with heart failure, while the role of sleep in sudden cardiac arrest survivors (SCA) has been only partially investigated and understood. Sleep-related breathing disorders and obstructive sleep apnoea increase illness and mortality in the aftermath of SCA. Also, post-traumatic stress is evident in SCA survivors, where sleep disruptions are some of the main symptoms of the condition. Consequently, it is important to identify sleep problems in SCA survivors at an early stage to avoid unnecessary suffering. AIM The aim of this study was to investigate registered nurses' perceptions of SCA survivors' sleep, both in hospital and after discharge. STUDY DESIGN This was an explorative interview study with a phenomenographic approach. Nineteen registered nurses (RNs) varying in age, sex and years in the profession participated. FINDINGS The nurses' perceptions of SCA survivors' sleep were categorized as: "The observer - noticing behaviours, emotions and habits of the patient that affect sleep", "The oblivious witness - attitudes that hinder the ability to recognise sleep behaviours", and "The practitioner - advising and medicating for sleep". The outcome space showed that the nurses detected both obvious and subtle signs relating to patients' sleep. However, attitudes hindering the recognition of sleep behaviours were independent of acting as an observer or practitioner. If nothing unforeseen was observed, or if the patient did not spontaneously raise the subject, sleep was considered less important than other health problems in SCA survivors. CONCLUSIONS Although the nurses knew that SCA survivors suffered from poor sleep, they failed to reflect on the consequences for the patient. Nurses' feelings of insufficient knowledge about sleep, as well as their omittance of sleep in the follow-up documentation could leave sleep issues unaddressed and cause unnecessary patient suffering. RELEVANCE TO CLINICAL PRACTICE Nurses need increased knowledge and training to enable them to detect subtle signs of sleep problems in SCA survivors.
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Affiliation(s)
- Amanda Hellström
- Faculty of Health and Life SciencesLinnaeus UniversityKalmar/VäxjöSweden
| | - Anders Bremer
- Faculty of Health and Life SciencesLinnaeus UniversityKalmar/VäxjöSweden
| | | | - Carina Hjelm
- Department of Health, Medicine and CareNursing and Reproductive Health Linköping UniversityLinköpingSweden
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Al-Badriyeh D, Hssain AA, Abushanab D. Cost-Effectiveness Analysis of Out-Of-Hospital versus In-Hospital Extracorporeal Cardiopulmonary Resuscitation for Out-Hospital Refractory Cardiac Arrest. Curr Probl Cardiol 2022; 47:101387. [PMID: 36070844 DOI: 10.1016/j.cpcardiol.2022.101387] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 08/29/2022] [Indexed: 11/24/2022]
Abstract
It has been speculated that out-of-hospital cardiac arrest (OHCA) patients' survival might be improved by implementing extracorporeal cardiopulmonary resuscitation (ECPR) before arrival to hospital. Therefore, we sought to assess the cost-effectiveness of OH-ECPR versus in-hospital (IH)-ECPR in OHCA patients in Qatar. From the hospital perspective, a conventional decision-analytic model was constructed to follow up the clinical and economic consequences of OH-ECPR versus IH-ECPR in a simulated OHCA population over one year. The primary outcome was the survival at discharge after arrest as well as the overall direct healthcare costs of managing OHCA patients. The robustness of this model was evaluated via sensitivity analyses. The OH-ECPR yielded 16% survival at discharge after arrest compared to 7% with IH-ECPR, [risk ratio (RR)=0.91; 95%CI 0.79 to 1.06; P=0.26]. Incorporating the uncertainty associated with this survival rate, and based on the estimated willingness to pay threshold in Qatar, the OH-ECPR was cost-effective with an incremental cost-effectiveness ratio of QAR 464,589 (USD 127,634). Sensitivity and uncertainty analyses confirmed the robustness of the study outcome. This is the first cost-effectiveness evaluation of OH-ECPR versus IH-ECPR in OHCA patients. OH-ECPR is potentially an economically acceptable resuscitative strategy in Qatar.
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Affiliation(s)
| | - Ali Ait Hssain
- Medical Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
| | - Dina Abushanab
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
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6
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Screening for neurocognitive impairment following out-of-hospital cardiac arrest: anyone for a MoCA? Resuscitation 2022; 172:137-138. [DOI: 10.1016/j.resuscitation.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 11/23/2022]
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7
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Heringhaus C, Bosch J, Oosterveer D, de Visser M. System-based interventions to improve outcome in out-of-hospital cardiac arrest patients: a Dutch experience. Eur J Emerg Med 2021; 28:416-417. [PMID: 34714813 DOI: 10.1097/mej.0000000000000887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | - Jan Bosch
- Department of Research and Development, Regional Ambulance Services Hollands Midden (RAVHM)
| | - Daniëlla Oosterveer
- Department of Rehabilitation, Basalt Rehabilitation Centre, Leiden, The Hague, the Netherlands
| | - Matthijs de Visser
- Department of Research and Development, Regional Ambulance Services Hollands Midden (RAVHM)
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Christensen J, Eskildsen SJ, Winkel BG, Dichman CK, Wagner MK. Motor and process skills in activities of daily living in survivors of out-of-hospital cardiac arrest: a cross-sectional study at hospital discharge. Eur J Cardiovasc Nurs 2021; 20:775-781. [PMID: 33755128 DOI: 10.1093/eurjcn/zvab020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/16/2020] [Accepted: 03/01/2021] [Indexed: 01/10/2023]
Abstract
AIMS An individuals' ability to perform basic activities of daily living (ADL) is said to be one of the strongest predictors of performance ability and independent living within the community. The Assessment of Motor and Process Skills (AMPS) tool was designed to assess global functional level during ADL by investigating motor and process skills. The purpose of this study was to assess ADL performance ability by investigating motor and process skills in a consecutive cohort of adult survivors of out-of-hospital cardiac arrest at the time of discharge from hospital. METHODS AND RESULTS This cross-sectional study uses data from a prospective cohort of cardiac arrest survivors admitted to the Copenhagen University Hospital, Rigshospitalet. The specific data used in this study were obtained at the time of the days or the day before hospital discharge. Adult survivors of out-of-hospital cardiac arrest due to cardiac causes were eligible for inclusion. Assessment of Motor and Process Skills was used to assess ADL performance ability by investigating motor and process skills. The ADL ability of 61 individuals was assessed. The mean ADL ability measures recorded were AMPS process 1.40 logits (0.48) and AMPS motor 1.82 logits (0.40). Based on the dichotomized AMPS results, 23% were most likely to need assistance to live independently in the community. CONCLUSION Performance ability during ADL revealed difficulty in the performance of process skill and an increased need for rehabilitation among survivors of out-of-hospital cardiac arrest at the time of hospital discharge.
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Affiliation(s)
- Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen East, Rigshospitalet, Denmark
| | - Signe Janum Eskildsen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen East, Rigshospitalet, Denmark
| | - Bo Gregers Winkel
- Department of Cardiology, Centre For Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen East, Rigshospitalet, Denmark
| | - Camilla Kofoed Dichman
- Department of Cardiology, Centre For Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen East, Rigshospitalet, Denmark
| | - Mette Kirstine Wagner
- Department of Cardiology, Centre For Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen East, Rigshospitalet, Denmark
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Larsson K, Bremer A, Årestedt K, Gunnarsson LL, Strömberg A, Hjelm C. Ways of understanding cognitive impairment in cardiac arrest survivors: A phenomenographic study. Intensive Crit Care Nurs 2020; 63:102994. [PMID: 33342651 DOI: 10.1016/j.iccn.2020.102994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/13/2020] [Accepted: 11/18/2020] [Indexed: 12/01/2022]
Abstract
AIM To describe the variation in ways that registered nurses perceive and understand cognitive impairment in cardiac arrest survivors. DESIGN A qualitative, inductive design with individual semi-structured interviews was applied. Data was analysed using a phenomenographic approach. SETTING The participants were nineteen Swedish registered nurses, experienced in cardiovascular care and providing follow-up care. FINDINGS The nurses perceived the cognitive impairment of the survivors in qualitatively different ways, as illustrated in two categories: 'The perceptible and obvious' and 'The elusive and challenging'. The nurses perceived a variety of signs of cognitive impairment, emotional expressions related to these, and recovery from cognitive impairment. They perceived confidence in capturing cognitive function when they understood the signs of cognitive impairment as severe and obvious. However, it was perceived as difficult to assess cognitive function when impairments were subtle, resulting in uncertainty in terms of how to make assessments. Nurses made use of their own strategies for assessments, which were sometimes found to be inadequate when they understood that they had misinterpreted the survivors' cognitive impairment. CONCLUSION Nurses feel uncertainty regarding detecting mild impairment in cardiac arrest survivors. By involving next of kin, nurses will gain a broader understanding of survivors' cognitive function.
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Affiliation(s)
- Karin Larsson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Anders Bremer
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Växjö, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Växjö, Sweden; The Research Section, Region Kalmar County, Kalmar, Sweden
| | | | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Cardiology, Linköping University, Linköping, Sweden
| | - Carina Hjelm
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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10
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Tang LH, Joshi V, Egholm CL, Zwisler AD. Are survivors of cardiac arrest provided with standard cardiac rehabilitation? - Results from a national survey of hospitals and municipalities in Denmark. Eur J Cardiovasc Nurs 2020; 20:115-123. [PMID: 33849060 DOI: 10.1177/1474515120946313] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/10/2020] [Indexed: 11/17/2022]
Abstract
AIM To quantify the provision of standard cardiac rehabilitation to Danish survivors of cardiac arrest at a programme level, and to analyse whether organizational factors influenced the provision. METHOD We mapped the provision of cardiac rehabilitation core components to survivors of cardiac arrest and compared this with a reference group of patients after acute myocardial infarction using data from a cross-sectional programme-level survey among all hospitals (n = 34) and municipalities (n = 98) in Denmark. Organizational factors of potential importance to service provision were considered: health care region, size of catchment area/population, type of department/municipality and socioeconomic index. RESULTS Response rates for the provision of each core component of cardiac rehabilitation ranged from 64% to 98%. All hospitals and municipalities provided some aspect of cardiac rehabilitation to survivors of cardiac arrest. Across hospitals, provision of four core components of cardiac rehabilitation to survivors of cardiac arrest was lower compared with post acute myocardial infarction patients: patient education (relative risk (RR) = 0.45 (95% confidence interval (CI) 0.27 to 0.75)), exercise training (RR = 0.69 (95% CI 0.49 to 0.98)), screening for anxiety and depression (RR = 0.64 (95% CI 0.46 to 0.90) and nutritional counselling RR = 0.76 (95% CI 0.62 to 0.93)). No difference was found in the provision of core components across municipalities. Overall, the provision of cardiac rehabilitation to survivors of cardiac arrest was not affected by organizational factors. CONCLUSION This study indicates a need for future research to inform the development, adoption and implementation of equal access to all components of cardiac rehabilitation for survivors of cardiac arrest in Denmark.
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Affiliation(s)
- Lars H Tang
- Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Odense, Denmark.,Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark.,Department of Regional Health Research, University of Southern Denmark, Slagelse, Denmark
| | - Vicky Joshi
- Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Cecilie Lindström Egholm
- Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Ann-Dorthe Zwisler
- Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Odense, Denmark.,The Danish Clinical Quality Program (RKKP), National Clinical Registries, Aarhus N, Denmark
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11
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Out-of-hospital cardiac arrest survivors need both cardiological and neurological rehabilitation! Curr Opin Crit Care 2019; 25:240-243. [DOI: 10.1097/mcc.0000000000000609] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Hofmeijer J, Hemels MEW. Recovery after cardiac arrest: the brain is the heart of the matter. Neth Heart J 2018; 26:484-485. [PMID: 30191536 PMCID: PMC6150872 DOI: 10.1007/s12471-018-1156-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- J Hofmeijer
- Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands. .,Clinical Neurophysiology, Technical Medical Center, University of Twente, Enschede, The Netherlands.
| | - M E W Hemels
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands.,Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
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