Telephone-based evaluation of cognitive impairment and mood disorders among out-of- hospital cardiac arrest survivors with good neurologic outcome: a retrospective cohort study

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Retrospective, cross-sectional, single-center study was performed, and a total of 97 patients were analyzed. Telephone version of Montreal Cognitive Assessment, Alzheimer’s disease-8 were used for evaluating cognitive dysfunctions, and the Patient Health Questionnaire-9 and the Hospital Anxiety and Depression Scale were used for assessing mood disorders. Quality of life was measured with the European Quality of Life 5-Dimension 5-Levels questionnaire. About one fourth patients experienced cognitive impairments (n = 23, 23.7%) or mood disorders (n = 28, 28.9%). Combined mood disorders (adjusted OR 21.36, 95% CI 5.14–88.84) and hospital length of stay (adjusted OR 1.04, 95% CI 1.01–1.08) were independent risk factors. In case of mood disorders, combined cognitive impairments (adjusted OR 9.94, 95% CI 2.83–35.97) and non-cardiac cause of cardiac arrest (adjusted OR 11.51, 95% CI 3.15–42.15) were risk factors. Furthermore, the quality of life was significantly low in the group with both cognitive impairments and mood disorders. Cognitive impairments and mood disorders were common among patients with good neurologic recovery. Health sciences/Medical research/Outcomes research Health sciences/Medical research/Epidemiology out-of-hospital cardiac arrest cognitive impairment mood disorder quality of life Figures Figure 1 Figure 2 Figure 3 Introduction Currently, approximately 6–11% of patients who experienced out-of-hospital cardiac arrest (OHCA) are discharged with neurologically intact survival, as defined by a Cerebral Performance Category (CPC) score ≤ 2 or Modified Rankin Scale score ≤ 3 1,2 . However, the consequences of cardiac arrest, even in cases of neurologically intact survival, can cause limitations in daily activities, participation in society, psychological condition, and quality of life (QoL) 3 . Several studies reported that OHCA survivors have cognitive impairments, predominantly regarding memory and executive functions, and emotional problems, including anxiety and depression, during long-term follow-up 4 , 5 . However, estimates of functional status after discharge of cardiac arrest survivors show a wide variation, ranging between 18–40% 6,7 . Considering that cognitive impairment and emotional distress among survivors of OHCA are critical aspects of returning to daily life, recent guidelines have described rehabilitation postcardiac arrest and emphasized the necessity of organized follow-up with screening assessments for cognitive and emotional problems 8 , 9 . However, limited evidence is available regarding standard tools and protocols for this screening. Extensive neuropsychological examination may be an ideal tool for detection; however, it is time consuming and causes discomfort as it requires patients and their caregivers to remain in the hospital. The telephone version of the mini Montreal Cognitive Assessment (T-mMoCA) and Alzheimer’s Disease 8 (AD-8) are widely used and extensively validated screening tools for examining individuals with mild cognitive impairment 10 . Similarly, with respect to mood disorders, the Patient Health Questionnaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS) are commonly employed to identify comorbid depression in patients with diverse medical illnesses 11 . This study evaluated the incidence of cognitive impairment and mood disorders by using previously described scoring systems with non-face-to-face examinations in patients who experienced OHCA survival with good neurologic outcome at the 6-month follow-up postcardiac arrest. We also investigated the association between the occurrence of each condition and QoL. Results During the study period, 364 adult patients survived OHCA and underwent targeted temperature management (Fig. 1 ). In the final analysis, 97 patients (75.3% men; median age: 54 years) were enrolled after excluding 267 patients due to in-hospital death (n = 123), poor neurologic outcomes at discharge (n = 134) and being unable/refusal for examination (n = 10). Among them, 23 (23.7%) patients showed cognitive impairment and 28 (28.9%) presented with emotional disorders. Tables 1 and 2 show the baseline characteristics of the study population according to cognitive impairment and mood disorders, respectively. Patients with cognitive impairments were older (57.0 vs. 52.0 years) and had more cases of non-cardiac origin arrest (43.5 vs. 14.9%) than those without cognitive dysfunction. Moreover, previous history of stroke (13.0 vs. 2.7%), diabetes mellitus (26.1 vs. 6.8%), initial asystole rhythm (17.4 vs. 2.7%), and longer duration of hospital length (20.0 vs. 15.0 days) were more frequent in patients with cognitive impairments than those without. With respect to mood disorders, male sex (67.9 vs. 78.3%) was less common (Table 2 ). Other medical causes of cardiac arrest (53.6 vs. 8.7%) were more common in patients with mood disorders. Resuscitation-related variables, including initial rhythm, duration, and postcardiac arrest syndrome treatment, were not statistically different between the groups. Table 1 Baseline characteristics of the study population according to cognitive impairment occurrence Variables Total (n = 97) No CI (n = 75) CI (n = 23) P Men 73 (75.3) 55 (74.3) 18 (78.3) 0.70 Age 54.0 (42.0–64.0) 52.0 (40.8–61.3) 57.0 (51.0–75.0) 0.05 Cardiac cause 76 (78.4) 63 (85.1) 13 (56.5) < 0.01 Other medical cause 21 (21.6) 11 (14.9) 10 (43.5) < 0.01 AMI 16 (16.5) 13 (17.6) 3 (13.0) 0.83 CKD 3 (3.1) 1 (1.4) 2 (8.7) 0.08 Arrhythmia 10 (10.3) 7 (9.5) 3 (13.0) 0.62 CHF 4 (4.1) 2 (2.7) 2 (8.7) 0.21 Stroke 5 (5.2) 2 (2.7) 3 (13.0) 0.05 HTN 31 (32.0) 20 (27.0) 11 (47.8) 0.06 DM 11 (11.3) 5 (6.8) 6 (26.1) 0.01 Malignancy 3 (3.1) 3 (4.1) 0 (0.0) 0.33 VF or VT 20 (20.6) 14 (18.9) 6 (26.1) 0.46 PEA 11 (11.3) 9 (12.2) 2 (8.7) 0.65 Asystole 6 (6.2) 2 (2.7) 4 (17.4) 0.01 Resuscitation, min 0.0 (0.0–0.95) 0.0 (0.0–5.5) 6.0 (0.0–12.0) 0.08 Total CPR duration 14.0 (8.0–25.5) 13.0 (7.8–26.3) 16.0 (9.0–25.0) 0.41 Witnessed arrest 83 (85.6) 65 (87.8) 18 (78.3) 0.25 Bystander CPR 68 (70.1) 52 (70.3) 16 (69.6) 0.85 ED shock 22 (22.7) 15 (20.3) 7 (30.4) 0.31 ECPR 9 (9.4) 9 (12.2) 22 (0.0) 0.09 Therapeutic hypothermia 87 (89.7) 65 (87.8) 22 (95.7) 0.28 MD 28 (28.9) 12 (16.2) 16 (69.6) < 0.01 ICU LOS, day 8.0 (6.0–10.0) 8.0 (6.0–10.0) 8.0 (6.0–11.0) 0.34 Hospital LOS, day 16.0 (12.0–21.0) 15.0 (12.0–20.0) 20.0 (13.0–37.0) 0.02 Data are presented as median (interquartile range) or number (percentage). Abbreviations: CI = cognitive impairment; AMI = acute myocardial infarction; CKD = chronic kidney disease; CHF = congestive heart failure; HTN = hypertension; DM = diabetes mellitus; VF = ventricular fibrillation; VT = ventricular tachycardia; PEA = pulseless electrical activity; ED = emergency department; CPR = cardiopulmonary resuscitation; ECPR = extracorporeal membrane oxygenation cardiopulmonary resuscitation; MD = mood disorder; ICU = intensive care unit; LOS = length of stay. Table 2 Baseline characteristics of the study population according to presence of mood disorders Variables Total (n = 97) No MD (n = 69) MD (n = 28) P Men 73 (75.3) 54 (78.3) 19 (67.9) 0.28 Age 54.0 (42.0–64.0) 55.0 (44.0–63.5) 51.5 (31.0–65.8) 0.46 Arrest causes Cardiac 76 (78.4) 63 (91.3) 13 (46.4) < 0.01 Other medical 21 (21.6) 6 (8.7) 15 (53.6) < 0.01 Past illnesses AMI 19 (19.6) 16 (23.1) 3 (10.7) 0.19 CKD 3 (3.1) 2 (2.9) 1 (3.6) 0.86 Arrhythmia 10 (10.3) 10 (14.5) 0 (0.0) 0.03 CHF 4 (4.1) 4 (5.8) 0 (0.0) 0.19 Stroke 5 (5.2) 1 (1.4) 4 (14.3) 0.01 HTN 31 (32.0) 20 (29.0) 11 (39.3) 0.32 DM 11 (11.3) 7 (10.1) 4 (14.3) 0.56 Malignancy 3 (3.1) 2 (2.9) 1 (3.6) 0.86 Initial rhythms VF or VT 20 (20.6) 13 (18.8) 7 (25.0) 0.50 PEA 11 (11.3) 8 (11.6) 3 (10.7) 0.90 Asystole 6 (6.2) 2 (2.9) 4 (14.3) 0.04 ED resuscitation time, min 0.0 (0.0–9.5) 0.0 (0.0–5.0) 3.0 (0.0–10.8) 0.21 Total CPR duration, min 14.0 (8.0–25.5) 15.0 (9.5–27.0) 12.0 (6.3–20.8) 0.14 Witnessed arrest 83 (85.6) 59 (85.5) 24 (85.7) 0.98 Bystander CPR 68 (70.1) 48 (69.6) 20 (71.5) 0.29 ED shock 22 (22.7) 15 (21.7) 7 (25.0) 0.73 ECPR 9 (9.4) 8 (11.8) 1 (3.6) 0.21 Therapeutic hypothermia 87 (89.7) 62 (89.9) 25 (89.3) 0.93 CI 23 (23.7) 7 (10.1) 16 (57.1) < 0.01 ICU LOS, day 8.0 (6.0–10.0) 8.0 (6.0–10.0) 8.5 (7.0–11.0) 0.30 Hospital LOS, day 16.0 (12.0–21.0) 15.0 (12.0–20.5) 18.0 (12.3–25.3) 0.35 Data are presented as median (interquartile range) or number (percentage). Abbreviations: MD = mood disorder; AMI = acute myocardial infarction; CKD = chronic kidney disease; CHF = congestive heart failure; HTN = hypertension; DM = diabetes mellitus; VF = ventricular fibrillation; VT = ventricular tachycardia; PEA = pulseless electrical activity; ED = emergency department; CPR = cardiopulmonary resuscitation; ECPR = extracorporeal membrane oxygenation cardiopulmonary resuscitation; CI = cognitive impairment; ICU = intensive care unit; LOS = length of stay. Figure 2 shows the details for each scoring system. The distribution of the total score was skewed to the left, which indicated that mild-to-moderate dysfunctions were common. All aspects, including verbal fluency (82.6%), delayed recall (95.6%), and orientation (87.0%), were affected in the T-mMoCA test. Additionally, almost 83% of the participants scored above the recommended AD-8 cut-off score of 2. Regarding mood disorders, the distributions of both PHQ-9 and HADS were not skewed and were evenly distributed. Univariate and multivariate logistic regression analyses for predicting cognitive impairment and mood disorder occurrence were performed (Table 3 and Table 4 , respectively). Combined mood disorders (adjusted odds ratio [OR] 21.36, 95% confidence interval [CI] 5.14–88.84), and duration of hospital stay (adjusted OR 1.04, 95% CI 1.01–1.08), were independent risk factors for cognitive impairment occurrence. With respect to mood disorders, combined cognitive impairment (adjusted OR 9.94, 95% CI 2.83–35.97) and non-cardiac cause of cardiac arrest (adjusted OR 11.51, 95% CI 3.15–42.15) were independent risk factors (Table 4 ). Table 3 Univariate and multivariate logistic regression for predicting cognitive impairment occurrence Variables Univariate Multivariate OR 95% CI P Adjusted OR 95% CI P Age > 52 5.06 1.00–25.52 0.05 4.16 0.91–19.06 0.07 Non-cardiac cause 1.23 0.24–6.20 0.80 DM 4.05 0.64–25.52 0.13 4.20 0.75–23.50 0.10 Asystole 3.59 0.27–47.85 0.33 Mood disorders 18.70 3.82–91.42 < 0.01 21.36 5.14–88.84 < 0.01 Stroke 0.97 0.06–15.07 0.98 Hospital LOS 1.04 1.00–1.07 0.03 1.04 1.01–1.07 0.01 ED CPR time 0.98 0.93–1.03 0.47 Abbreviations: OR = odds ratio; CI = confidence interval; DM = diabetes mellitus; LOS = length of stay; ED = emergency department; CPR = cardiopulmonary resuscitation. Table 4 Univariate and multivariate logistic regression for predicting occurrence of mood disorders Variables Univariate Multivariate OR 95% CI P Adjusted OR 95% CI P Age above 55 0.97 0.93–1.01 0.17 Non-cardiac cause 8.45 2.09–34.10 < 0.01 11.51 3.15–42.15 < 0.01 Stroke 21.34 1.26–36.39 0.03 12.87 0.89–18.71 0.06 Asystole 1.46 0.08–27.32 0.08 Male 0.96 0.23–4.00 0.96 Cognitive impairments 14.14 3.25–61.46 < 0.01 9.94 2.83–34.97 < 0.01 Abbreviations: OR = odds ratio; CI = confidence interval. Figure 3 presents the comparison between QoL according to each impairment. EQ utility indexes and EQ-VAS showed similar trends in that the patients in each disorder had significantly lower QoL than that of those without disorders. Discussion In this cross-sectional study, we found that approximately a quarter of the patients with a favorable neurologic outcome from OHCA experienced cognitive impairment or mood disorders by using a telephone-based evaluation. Each condition was identified as an independent risk factor for one another, and the QoL was significantly lower in the group with both cognitive impairment and mood disorders than in the group with disorders. Enhanced survival rates have not always been accompanied by an increased incidence of favorable neurologic outcomes. Moreover, it is not uncommon that patients with a good CPC score still have some degrees of ischemic and reperfusion brain damage due to global hypoxia 12 , 13 . The distribution of typically affected areas include the medial temporal lobes, neocortex, and cerebellum, which were related to impairments in the memory and executive function 14 . Frontotemporal involvement was also reported in ischemic brain injury and correlates with inappropriate behavior and social maladjustment 14 . Our study revealed that delayed recall and verbal fluency were largely affected by OHCA, but orientation was only slightly affected. These findings were similar with previous reports that stated the hippocampus, located in the medial temporal lobe, is a hypoxia-sensitive region, and that memory impairments are more prevalent among survivors of cardiac arrest than with other cognitive impairments 12 , 15 . Previous studies have described the incidence of cognitive impairment and mood disorders to range between 18–40% among survivors of OHCA 16 . This large variation is largely due to the lack of standardized assessments and data on optimal timing for screening. Most previous studies had enrolled a relatively small number of patients because traditional tools for neuropsychologic examination are time-consuming and need expertized personnel for individual tests 13 . The rapid expansion of remotely administered screening tools for cognitive impairment and mood disorders, which are increasingly becoming necessary in clinical settings, has far-reaching applications for patient follow-up and monitoring. In the present study, we used the T-mMoCA test and AD-8, which have been developed and validated for patients with Alzheimer’s disease. The incidence of cognitive impairment (23.7%) and emotional disorders (28.9%) 6 months after the cardiac arrest is consistent with that of previous studies 4 , 17 . Accordingly, this implied that the telephone version of T-mMoCA and AD-8 for cognitive impairment and PHQ-9 and HADS for mood disorders are feasible screening tools in OHCA survivors for long-term follow-up. Although a substantial portion of cognitive improvement occurs in the first 3 months following cardiac arrest, health-related QoL can only be adequately assessed when the patient is allowed to interact with their social environment 18 , 19 . Hence, we evaluated cognitive and mood impairments in neurologically intact survivors during the 6-month follow-up; however, the optimal timing of function evaluation in postcardiac arrest survivors still remains unknown. Serial evaluation of cognitive and mood impairment starting from 3 months after the cardiac arrest will be more sensitive for impairment detection, and further studies are needed to confirm this. It is interesting to observe that Sandroni et al. found that women are less likely than men to achieve a good QoL after cardiac arrest 20 . However, our results showed no sex differences in the development of cognitive impairment and emotional disorders. In the logistic regression analysis, cognitive impairment and mood disorders were independent risk factors for one another. Previous neuropsychological studies revealed that cognition and emotion often interact 21 , and among the various domains of cognitive function, memory and recall were largely influenced by the patient’s emotional state 22 . Therefore, cognitive dysfunction and mood disorders may share a majority of symptoms, making it difficult to distinguish them. Our study also demonstrated that most of the patients experienced both conditions simultaneously, and that they were not mutually exclusive. This may be the result of the fact that hypoxic brain injury involves various brain regions at the same time, including the prefrontal cortex, subcortical regions, temporal lobes, and hippocampus. Damage to these areas influences not only memory and executive functions, but also depressive states. Moreover, one deficit could lead to another deficit. For example, patients with cognitive dysfunction may be more likely to develop depressive episodes than patients without it. Similarly, depression might be associated with an increased risk of cognitive disturbance occurrence. However, because of the present study’s retrospective design, we could not confirm the causality of each condition. Our study had several limitations. First, although this was the first investigation to reveal the incidence of cognitive impairment and mood disorders among survivors of OHCA in South Korea, its results cannot be generalized to other environments as it was conducted in a single, urban hospital. Second, we did not have the baseline cognitive function and mood status before OHCA; thus, we assumed that all impairments were attributable to OHCA. Finally, hidden confounders, such as education level, financial status, and familiar support, could affect the occurrence of cognitive dysfunction and mood disorders. In OHCA survivors with favorable neurologic outcomes at 6 months postcardiac arrest, 23.7% had cognitive impairment, and 28.9% had emotional disorders, as determined by telephone-based evaluation. Furthermore, both the conditions were associated with a low QoL, necessitating appropriate screening and active intervention. In view of the wide variations regarding impairment incidence and the absence of standard assessment tools for postcardiac arrest survivors in contemporary clinical practice, our telephone-based evaluation will be a convenient and simple tool. Methods Study design and participants This was a retrospective, cross-sectional, single-center study conducted at a urban, tertiary hospital located in Seoul, with nearly 400 OHCA cases and 120,000 adult patients annually admitted to the emergency department (ED). Our hospital has prospectively registered comatose survival since 2012, not only for patient monitoring and improving outcomes, but for systemic research as well 23 . The inclusion criteria were patients who underwent targeted temperature treatment. Pediatric patients (< 19 years old), those with trauma, terminal illnesses, do-not-resuscitate order, those who refused target temperature management or intensive care unit care admission, or were transferred due to the lack of room for admission were excluded from this registry. The registry included epidemiological and clinical data, such as prehospital data, ED resuscitation according to Utstein guidelines, and postcardiac arrest syndrome care-related factors 24 . The clinical outcomes also included duration of hospital stay, survival discharge, and neurologic outcomes. Neurologic outcomes were evaluated with CPC at discharge by emergency medicine physicians on duty and 6 months later by physicians using a telephone-based method. Among previously enrolled patients on the registry, we extracted patients those who had favorable neurologic outcomes (i.e., CPC 1 or 2) at both discharge and the 6-month follow-up between 2012 and 2021. We thoroughly explained the study design to the patients and obtained informed consent using the telephone. Patients were excluded if they refused to participate in the study and did not have the necessary spoken language skills. This study was approved by the Institutional Review Board of the Asan Medical Center (study no. 2021 − 1170). All methods were performed in accordance with the relevant guidelines and regulations. Measures Experienced emergency physicians (K.J.S. and K.Y.J.) interviewed the participants through telephone and in-person assessments to screen cognitive and mood disorders. The T-mMoCA assesses digit numbering, attention, calculation, repetition, fluency, abstraction, delayed recall, and orientation and, excluding the visual tests, has a maximum score of 22 points 25 . The AD-8 is an 8-item questionnaire that evaluates memory, orientation, executive functioning, and interest in activities with a total score of 8 points (i.e., yes or no answers for each question) 26 . The PHQ-9 is a self-rating questionnaire consisting of nine items in accordance with the Diagnostic and Statistical Manual of Mental Disorder. Responders score each item from 0–3 based on the frequency of their experience over their past 2-week period (not at all, several days, more than half the days, or nearly every day), with a maximum score of 27 points 27 . The HADS rating scale is compounded of 14 items, 7 of which are related to anxiety and 7 to depression 28 . Each of the items is scored on a 4-point scale from 0–3, with the final score ranging between 0–21. Cut-off values for each screening assessment are based on previous research and are presented in Supplementary Table S1 . QoL was measured with the European Quality of Life 5-Dimension 5-Levels questionnaire (EQ-5D-5L) and visual analogue scale (EQ-VAS). The EQ-5D-5L is scored on a 5-point (a smaller score indicated a more positive outcome) and combined to form a 5-digit score, which is then converted into a EQ utility index based on set values obtained from a reference population 29 . We extracted demographic data, including age, sex, and comorbidities, from the registry. Arrhythmia included any underlying arrhythmia that required treatment, such as medication, implantable cardioverter defibrillator, pacemaker, or catheter ablation, before cardiac arrest. Malignancy was defined as active cancer confirmed through histologic or cytological before cardiac arrest or recurrent or metastatic cancer not in complete remission from a hematologic malignancy. Furthermore, prehospital and ED resuscitation-related factors were extracted according to the Utstein guidelines. Presumed causes of cardiac arrest were recorded by physicians on duty and divided into two categories (i.e., cardiac and other medical). Postcardiac arrest care-related data and clinical outcomes, such as percutaneous cardiac intervention, extracorporeal corporeal membrane oxygenation, duration of intensive care unit stay, and duration of hospital stay, were collected from electronic medical records. Statistical analysis Descriptive analyses were conducted to compare baseline characteristics with respect to cognitive impairment and mood disorders. Categorical variables were presented as percentages and were analyzed using chi-square tests; meanwhile, non-normally distributed continuous variables were represented as medians with interquartile ranges and were compared using the Mann–Whitney U tests. Independent risk factors for the occurrence of each condition were determined by backward step-wise multivariate logistic regression analyses with statistically significant variables ( P < 0.1) from the univariate analysis. All statistical analyses were performed using SPSS version 21.0 (IBM Corp., Armonk, NY, USA), with P values < 0.05 considered statistically significant. Declarations Author contributions J.S.K. designed study, analyzed data, and wrote the manuscript. Y.J.K. contributed to analyzing the data and preparing figures. S.M.R, and S.A. collected data and revised the manuscript. W.Y.K. supervised and provided review of the draft. All authors reviewed the manuscript. Data availability The datasets of this study can be obtained from the corresponding author on reasonable request. Funding This research was supported by 2021 science research program through the Korean Association of Cardiopulmonary Resuscitation (KACPR) (No. 2021-004) Competing interests The authors declare no competing interests. References Yan, S. et al. The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis. Crit Care 24, 61 (2020). Chin, Y. H. et al. Long-term outcomes after out-of-hospital cardiac arrest: A systematic review and meta-analysis. Resuscitation 171, 15–29 (2022). Wimmer, H. et al. Health-related quality of life after out-of-hospital cardiac arrest – a five-year follow-up studyJūratė Šaltytė Benth. Resuscitation 162, 372–380 (2021). Lilja, G. et al. Cognitive function in survivors of out-of-hospital cardiac arrest after target temperature management at 33°C versus 36°C. Circulation 131, 1340–1349 (2015). Lilja, G. et al. Anxiety and depression among out-of-hospital cardiac arrest survivors. Resuscitation 97, 68–75 (2015). Andrew, E., Nehme, Z., Bernard, S. & Smith, K. Comparison of health-related quality of life and functional recovery measurement tools in out-of-hospital cardiac arrest survivors. Resuscitation 107, 57–64 (2016). Lilja, G. et al. Return to work and participation in society after out-of-hospital cardiac arrest. Circulation Cardiovasc Qual Outcomes 11, e003566 (2018). Panchal, A. R. et al. Part 3: Adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 142, S366–S468 (2020). Nolan, J. P. et al. European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care. Resuscitation 161, 220–269 (2021). Overton, E. T. et al. The Alzheimer’s disease-8 and Montreal Cognitive Assessment as screening tools for neurocognitive impairment in HIV-infected persons. J Neurovirol 19, 109–116 (2013). Hansson, M., Chotai, J., Nordstöm, A. & Bodlund, O. Comparison of two self-rating scales to detect depression: HADS and PHQ-9. Br J Gen Pract 59, e283–e288 (2009). Sabedra, A. R. et al. Neurocognitive outcomes following successful resuscitation from cardiac arrest. Resuscitation 90, 67–72 (2015). Zook, N. et al. Neurocognitive function following out-of-hospital cardiac arrest: A systematic review. Resuscitation 170, 238–246 (2022). Moulaert, V. R. M. P., Verbunt, J. A., Heugten, C. M. van & Wade, D. T. Cognitive impairments in survivors of out-of-hospital cardiac arrest: A systematic review. Resuscitation 80, 297–305 (2009). Cronberg, T., Lilja, G., Rundgren, M., Friberg, H. & Widner, H. Long-term neurological outcome after cardiac arrest and therapeutic hypothermia. Resuscitation 80, 1119–1123 (2009). Lundgren-Nilsson, Å., Rosén, H., Hofgren, C. & Sunnerhagen, K. S. The first year after successful cardiac resuscitation: Function, activity, participation and quality of life. Resuscitation 66, 285–289 (2005). Duits, A., Munnecom, T., Heugten, C. van & Oostenbrugge, R. J. van. Cognitive complaints in the early phase after stroke are not indicative of cognitive impairment. J Neurology Neurosurg Psychiatry 79, 143 (2008). Steinbusch, C. V. M., Heugten, C. M. van, Rasquin, S. M. C., Verbunt, J. A. & Moulaert, V. R. M. Cognitive impairments and subjective cognitive complaints after survival of cardiac arrest: A prospective longitudinal cohort study. Resuscitation 120, 132–137 (2017). Lazzarin, T. et al. Post-Cardiac Arrest: Mechanisms, Management, and Future Perspectives. J Clin Medicine 12, 259 (2022). Sandroni, C., Cronberg, T. & Sekhon, M. Brain injury after cardiac arrest: pathophysiology, treatment, and prognosis. Intensive Care Med 47, 1393–1414 (2021). Zlatar, Z. Z., Moore, R. C., Palmer, B. W., Thompson, W. K. & Jeste, D. V. Cognitive complaints correlate with depression rather than concurrent objective cognitive impairment in the successful aging evaluation baseline sample. J Geriatr Psych Neur 27, 181–187 (2013). Langa, K. M. & Levine, D. A. The diagnosis and management of mild cognitive impairment: A clinical review. Jama 312, 2551–2561 (2014). Kim, J. et al. Impact of lung compliance on neurological outcome in patients with acute respiratory distress syndrome following out-of-hospital cardiac arrest. J Clin Medicine 9, 527 (2020). Idris, A. H. et al. 2015 Revised Utstein-Style Recommended Guidelines for Uniform Reporting of Data From Drowning-Related Resuscitation: An ILCOR Advisory Statement. Circulation Cardiovasc Qual Outcomes 10, e000024 (2018). Wong, A. et al. The Montreal Cognitive Assessment 5-minute protocol is a brief, valid, reliable, and feasible cognitive screen for telephone administration. Stroke 46, 1059–1064 (2015). Galvin, J. E. et al. The AD8. Neurology 65, 559–564 (2005). Kurt, K., L, S. R. & W, W. J. B. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 9, 606–613 (2001). Bjelland, I., Dahl, A. A., Haug, T. T. & Neckelmann, D. The validity of the Hospital Anxiety and Depression Scale An updated literature review. J Psychosom Res 52, 69–77 (2002). Herdman, M. et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 20, 1727–1736 (2011). Additional Declarations No competing interests reported. Supplementary Files Additionalfile1.pdf Cite Share Download PDF Status: Published Journal Publication published 23 Oct, 2023 Read the published version in Scientific Reports → Version 1 posted Editorial decision: Major revision 03 Aug, 2023 Reviews received at journal 02 Aug, 2023 Reviewers agreed at journal 28 Jul, 2023 Reviews received at journal 22 Jul, 2023 Reviewers agreed at journal 13 Jul, 2023 Reviewers invited by journal 12 Jul, 2023 Editor assigned by journal 29 Jun, 2023 Editor invited by journal 18 Mar, 2023 Submission checks completed at journal 18 Mar, 2023 First submitted to journal 10 Mar, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2679692","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":184539786,"identity":"10531eaa-b848-4de6-9e1d-b37f4fa362e4","order_by":0,"name":"June-sung Kim","email":"","orcid":"","institution":"University of Ulsan College of Medicine, Asan Medical Center","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"June-sung","middleName":"","lastName":"Kim","suffix":""},{"id":184539787,"identity":"89de3cd2-c3fc-4040-8583-731ee866b835","order_by":1,"name":"Youn-Jung Kim","email":"","orcid":"","institution":"University of Ulsan College of Medicine, Asan Medical Center","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Youn-Jung","middleName":"","lastName":"Kim","suffix":""},{"id":184539788,"identity":"ab2e2607-8fcd-4732-b1ae-6bcb30b35086","order_by":2,"name":"Seung Mok Ryoo","email":"","orcid":"","institution":"University of Ulsan College of Medicine, Asan Medical Center","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Seung","middleName":"Mok","lastName":"Ryoo","suffix":""},{"id":184539789,"identity":"41c5e580-ccda-44b9-a6d5-7402589d4923","order_by":3,"name":"Shin Ahn","email":"","orcid":"","institution":"University of Ulsan College of Medicine, Asan Medical Center","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Shin","middleName":"","lastName":"Ahn","suffix":""},{"id":184539790,"identity":"9412136c-d530-4cb4-847b-32732631826b","order_by":4,"name":"Won Young Kim","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwklEQVRIiWNgGAWjYLCCBIb/dvykamFOlmwg0R5mxg0HiFVrcLz32IMHNWzMxrebn0l83MMgzy9GQLPBmXPpBgnHePjM7hwzk5zxjMFw5uwE/FrMbuSYSSSwSTCb3UgwNuY5wJBgcJsoLf8MGDfPSP9s/IdoLYltCYwbJHIMHzMQo8X+zBlzg8S+A8kSN3IKH/YckCDsF8n2HrOHP74dsOOfkb7hwI8DNvL80gS0AAEbMkeCoHIMLaNgFIyCUTAKMAEA1g9EPE94TJAAAAAASUVORK5CYII=","orcid":"","institution":"University of Ulsan College of Medicine, Asan Medical Center","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Won","middleName":"Young","lastName":"Kim","suffix":""}],"badges":[],"createdAt":"2023-03-11 01:29:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2679692/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2679692/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41598-023-44963-1","type":"published","date":"2023-10-23T15:02:17+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":34597069,"identity":"e3255a77-b207-403b-bb5f-58c2e18a1629","added_by":"auto","created_at":"2023-03-21 15:44:14","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":61896,"visible":true,"origin":"","legend":"\u003cp\u003eStudy flowchart. OHCA: out-of-hospital cardiac arrest; TTM: targeted temperature management; CPC: cerebral performance category\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2679692/v1/e886fbf369c8a39514deeeeb.jpg"},{"id":34597833,"identity":"af24b7d5-d066-48de-8416-6e5d55b3ca0e","added_by":"auto","created_at":"2023-03-21 15:52:14","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":86843,"visible":true,"origin":"","legend":"\u003cp\u003eDetails of each scoring tool. Figure shows scoring of verbal fluency (A), delayed recall (B), orientation (C), T-mMoCA total (D), K-AD8 (E), PHQ9 (F), HADS (G).\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2679692/v1/709646fa69a2e2882101e2cb.jpg"},{"id":34598247,"identity":"a1a8791a-8705-4fae-8eac-f8ea2aeec1a9","added_by":"auto","created_at":"2023-03-21 16:00:14","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":97415,"visible":true,"origin":"","legend":"\u003cp\u003eQuality of life for each impairment. Comparisons of EQ utility index of those who had cognitive impairments and had no cognitive impairments (A), those who had mood disorders and had no mood disorders (B), EQ VAS score of those who had cognitive impairments and had no cognitive impairments (C), those who had mood disorders and had no mood disorders (D).\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-2679692/v1/74d3b34421a06dbe0b928c4b.jpg"},{"id":45453885,"identity":"f4cdb1ed-1a91-41f6-b12e-c1759124ece4","added_by":"auto","created_at":"2023-10-30 15:07:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":472612,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2679692/v1/67d2ba38-e3e3-40a4-94fa-38f802563fca.pdf"},{"id":34597070,"identity":"dd5a4201-ec53-42b6-a444-0ac89c9cbb95","added_by":"auto","created_at":"2023-03-21 15:44:14","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":63360,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2679692/v1/803a1341f37eb04b22d4f339.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Telephone-based evaluation of cognitive impairment and mood disorders among out-of- hospital cardiac arrest survivors with good neurologic outcome: a retrospective cohort study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCurrently, approximately 6\u0026ndash;11% of patients who experienced out-of-hospital cardiac arrest (OHCA) are discharged with neurologically intact survival, as defined by a Cerebral Performance Category (CPC) score\u0026thinsp;\u0026le;\u0026thinsp;2 or Modified Rankin Scale score\u0026thinsp;\u0026le;\u0026thinsp;3 \u003csup\u003e1,2\u003c/sup\u003e. However, the consequences of cardiac arrest, even in cases of neurologically intact survival, can cause limitations in daily activities, participation in society, psychological condition, and quality of life (QoL) \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. Several studies reported that OHCA survivors have cognitive impairments, predominantly regarding memory and executive functions, and emotional problems, including anxiety and depression, during long-term follow-up \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. However, estimates of functional status after discharge of cardiac arrest survivors show a wide variation, ranging between 18\u0026ndash;40% \u003csup\u003e6,7\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eConsidering that cognitive impairment and emotional distress among survivors of OHCA are critical aspects of returning to daily life, recent guidelines have described rehabilitation postcardiac arrest and emphasized the necessity of organized follow-up with screening assessments for cognitive and emotional problems \u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. However, limited evidence is available regarding standard tools and protocols for this screening. Extensive neuropsychological examination may be an ideal tool for detection; however, it is time consuming and causes discomfort as it requires patients and their caregivers to remain in the hospital. The telephone version of the mini Montreal Cognitive Assessment (T-mMoCA) and Alzheimer\u0026rsquo;s Disease 8 (AD-8) are widely used and extensively validated screening tools for examining individuals with mild cognitive impairment \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. Similarly, with respect to mood disorders, the Patient Health Questionnaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS) are commonly employed to identify comorbid depression in patients with diverse medical illnesses \u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThis study evaluated the incidence of cognitive impairment and mood disorders by using previously described scoring systems with non-face-to-face examinations in patients who experienced OHCA survival with good neurologic outcome at the 6-month follow-up postcardiac arrest. We also investigated the association between the occurrence of each condition and QoL.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eDuring the study period, 364 adult patients survived OHCA and underwent targeted temperature management (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). In the final analysis, 97 patients (75.3% men; median age: 54 years) were enrolled after excluding 267 patients due to in-hospital death (n\u0026thinsp;=\u0026thinsp;123), poor neurologic outcomes at discharge (n\u0026thinsp;=\u0026thinsp;134) and being unable/refusal for examination (n\u0026thinsp;=\u0026thinsp;10). Among them, 23 (23.7%) patients showed cognitive impairment and 28 (28.9%) presented with emotional disorders.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eTables\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e show the baseline characteristics of the study population according to cognitive impairment and mood disorders, respectively. Patients with cognitive impairments were older (57.0 vs. 52.0 years) and had more cases of non-cardiac origin arrest (43.5 vs. 14.9%) than those without cognitive dysfunction. Moreover, previous history of stroke (13.0 vs. 2.7%), diabetes mellitus (26.1 vs. 6.8%), initial asystole rhythm (17.4 vs. 2.7%), and longer duration of hospital length (20.0 vs. 15.0 days) were more frequent in patients with cognitive impairments than those without. With respect to mood disorders, male sex (67.9 vs. 78.3%) was less common (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Other medical causes of cardiac arrest (53.6 vs. 8.7%) were more common in patients with mood disorders. Resuscitation-related variables, including initial rhythm, duration, and postcardiac arrest syndrome treatment, were not statistically different between the groups.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline characteristics of the study population according to cognitive impairment occurrence\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;97)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo CI (n\u0026thinsp;=\u0026thinsp;75)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCI (n\u0026thinsp;=\u0026thinsp;23)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e73 (75.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55 (74.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (78.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e54.0 (42.0\u0026ndash;64.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52.0 (40.8\u0026ndash;61.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57.0 (51.0\u0026ndash;75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e 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(43.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (16.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCKD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArrhythmia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCHF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (4.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (5.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHTN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31 (32.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20 (27.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (47.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (11.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (6.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6 (26.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalignancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (4.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVF or VT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20 (20.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (18.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6 (26.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePEA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (11.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (12.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsystole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (17.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResuscitation, min\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.0 (0.0\u0026ndash;0.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0 (0.0\u0026ndash;5.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.0 (0.0\u0026ndash;12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal CPR duration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14.0 (8.0\u0026ndash;25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.0 (7.8\u0026ndash;26.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.0 (9.0\u0026ndash;25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWitnessed arrest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83 (85.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65 (87.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (78.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBystander CPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68 (70.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52 (70.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16 (69.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eED shock\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (22.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (20.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (30.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eECPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9 (9.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (12.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTherapeutic hypothermia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e87 (89.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65 (87.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22 (95.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28 (28.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (16.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16 (69.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICU LOS, day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.0 (6.0\u0026ndash;10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.0 (6.0\u0026ndash;10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.0 (6.0\u0026ndash;11.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital LOS, day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16.0 (12.0\u0026ndash;21.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.0 (12.0\u0026ndash;20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.0 (13.0\u0026ndash;37.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eData are presented as median (interquartile range) or number (percentage).\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eAbbreviations: CI\u0026thinsp;=\u0026thinsp;cognitive impairment; AMI\u0026thinsp;=\u0026thinsp;acute myocardial infarction; CKD\u0026thinsp;=\u0026thinsp;chronic kidney disease; CHF\u0026thinsp;=\u0026thinsp;congestive heart failure; HTN\u0026thinsp;=\u0026thinsp;hypertension; DM\u0026thinsp;=\u0026thinsp;diabetes mellitus; VF\u0026thinsp;=\u0026thinsp;ventricular fibrillation; VT\u0026thinsp;=\u0026thinsp;ventricular tachycardia; PEA\u0026thinsp;=\u0026thinsp;pulseless electrical activity; ED\u0026thinsp;=\u0026thinsp;emergency department; CPR\u0026thinsp;=\u0026thinsp;cardiopulmonary resuscitation; ECPR\u0026thinsp;=\u0026thinsp;extracorporeal membrane oxygenation cardiopulmonary resuscitation; MD\u0026thinsp;=\u0026thinsp;mood disorder; ICU\u0026thinsp;=\u0026thinsp;intensive care unit; LOS\u0026thinsp;=\u0026thinsp;length of stay.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline characteristics of the study population according to presence of mood disorders\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;97)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo MD (n\u0026thinsp;=\u0026thinsp;69)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMD (n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e73 (75.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54 (78.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19 (67.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e54.0 (42.0\u0026ndash;64.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55.0 (44.0\u0026ndash;63.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.5 (31.0\u0026ndash;65.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArrest causes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCardiac\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e76 (78.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e63 (91.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13 (46.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther medical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21 (21.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15 (53.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePast illnesses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (23.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCKD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArrhythmia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (14.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCHF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (4.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (5.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (5.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (14.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHTN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31 (32.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20 (29.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (39.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (11.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (10.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (14.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalignancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInitial rhythms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVF or VT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20 (20.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePEA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (11.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (11.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsystole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (14.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eED resuscitation time, min\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.0 (0.0\u0026ndash;9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.0 (0.0\u0026ndash;5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.0 (0.0\u0026ndash;10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal CPR duration, min\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14.0 (8.0\u0026ndash;25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.0 (9.5\u0026ndash;27.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.0 (6.3\u0026ndash;20.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWitnessed arrest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83 (85.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59 (85.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24 (85.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBystander CPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68 (70.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48 (69.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20 (71.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eED shock\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (22.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (21.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eECPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9 (9.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (11.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTherapeutic hypothermia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e87 (89.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e62 (89.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25 (89.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23 (23.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (10.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16 (57.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICU LOS, day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.0 (6.0\u0026ndash;10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.0 (6.0\u0026ndash;10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.5 (7.0\u0026ndash;11.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital LOS, day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16.0 (12.0\u0026ndash;21.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.0 (12.0\u0026ndash;20.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.0 (12.3\u0026ndash;25.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eData are presented as median (interquartile range) or number (percentage).\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eAbbreviations: MD\u0026thinsp;=\u0026thinsp;mood disorder; AMI\u0026thinsp;=\u0026thinsp;acute myocardial infarction; CKD\u0026thinsp;=\u0026thinsp;chronic kidney disease; CHF\u0026thinsp;=\u0026thinsp;congestive heart failure; HTN\u0026thinsp;=\u0026thinsp;hypertension; DM\u0026thinsp;=\u0026thinsp;diabetes mellitus; VF\u0026thinsp;=\u0026thinsp;ventricular fibrillation; VT\u0026thinsp;=\u0026thinsp;ventricular tachycardia; PEA\u0026thinsp;=\u0026thinsp;pulseless electrical activity; ED\u0026thinsp;=\u0026thinsp;emergency department; CPR\u0026thinsp;=\u0026thinsp;cardiopulmonary resuscitation; ECPR\u0026thinsp;=\u0026thinsp;extracorporeal membrane oxygenation cardiopulmonary resuscitation; CI\u0026thinsp;=\u0026thinsp;cognitive impairment; ICU\u0026thinsp;=\u0026thinsp;intensive care unit; LOS\u0026thinsp;=\u0026thinsp;length of stay.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the details for each scoring system. The distribution of the total score was skewed to the left, which indicated that mild-to-moderate dysfunctions were common. All aspects, including verbal fluency (82.6%), delayed recall (95.6%), and orientation (87.0%), were affected in the T-mMoCA test. Additionally, almost 83% of the participants scored above the recommended AD-8 cut-off score of 2. Regarding mood disorders, the distributions of both PHQ-9 and HADS were not skewed and were evenly distributed.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eUnivariate and multivariate logistic regression analyses for predicting cognitive impairment and mood disorder occurrence were performed (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, respectively). Combined mood disorders (adjusted odds ratio [OR] 21.36, 95% confidence interval [CI] 5.14\u0026ndash;88.84), and duration of hospital stay (adjusted OR 1.04, 95% CI 1.01\u0026ndash;1.08), were independent risk factors for cognitive impairment occurrence. With respect to mood disorders, combined cognitive impairment (adjusted OR 9.94, 95% CI 2.83\u0026ndash;35.97) and non-cardiac cause of cardiac arrest (adjusted OR 11.51, 95% CI 3.15\u0026ndash;42.15) were independent risk factors (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate and multivariate logistic regression for predicting cognitive impairment occurrence\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eUnivariate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eMultivariate\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAdjusted OR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u0026thinsp;\u0026gt;\u0026thinsp;52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u0026ndash;25.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.91\u0026ndash;19.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-cardiac cause\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.24\u0026ndash;6.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.64\u0026ndash;25.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.75\u0026ndash;23.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsystole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.27\u0026ndash;47.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMood disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.82\u0026ndash;91.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5.14\u0026ndash;88.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.06\u0026ndash;15.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital LOS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u0026ndash;1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.01\u0026ndash;1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eED CPR time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.93\u0026ndash;1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eAbbreviations: OR\u0026thinsp;=\u0026thinsp;odds ratio; CI\u0026thinsp;=\u0026thinsp;confidence interval; DM\u0026thinsp;=\u0026thinsp;diabetes mellitus; LOS\u0026thinsp;=\u0026thinsp;length of stay; ED\u0026thinsp;=\u0026thinsp;emergency department; CPR\u0026thinsp;=\u0026thinsp;cardiopulmonary resuscitation.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate and multivariate logistic regression for predicting occurrence of mood disorders\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eUnivariate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eMultivariate\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAdjusted OR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge above 55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.93\u0026ndash;1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-cardiac cause\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.09\u0026ndash;34.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.15\u0026ndash;42.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.26\u0026ndash;36.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.89\u0026ndash;18.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsystole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.08\u0026ndash;27.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.23\u0026ndash;4.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCognitive impairments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.25\u0026ndash;61.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.83\u0026ndash;34.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eAbbreviations: OR\u0026thinsp;=\u0026thinsp;odds ratio; CI\u0026thinsp;=\u0026thinsp;confidence interval.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the comparison between QoL according to each impairment. EQ utility indexes and EQ-VAS showed similar trends in that the patients in each disorder had significantly lower QoL than that of those without disorders.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this cross-sectional study, we found that approximately a quarter of the patients with a favorable neurologic outcome from OHCA experienced cognitive impairment or mood disorders by using a telephone-based evaluation. Each condition was identified as an independent risk factor for one another, and the QoL was significantly lower in the group with both cognitive impairment and mood disorders than in the group with disorders.\u003c/p\u003e \u003cp\u003eEnhanced survival rates have not always been accompanied by an increased incidence of favorable neurologic outcomes. Moreover, it is not uncommon that patients with a good CPC score still have some degrees of ischemic and reperfusion brain damage due to global hypoxia \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. The distribution of typically affected areas include the medial temporal lobes, neocortex, and cerebellum, which were related to impairments in the memory and executive function \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Frontotemporal involvement was also reported in ischemic brain injury and correlates with inappropriate behavior and social maladjustment \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Our study revealed that delayed recall and verbal fluency were largely affected by OHCA, but orientation was only slightly affected. These findings were similar with previous reports that stated the hippocampus, located in the medial temporal lobe, is a hypoxia-sensitive region, and that memory impairments are more prevalent among survivors of cardiac arrest than with other cognitive impairments \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003ePrevious studies have described the incidence of cognitive impairment and mood disorders to range between 18\u0026ndash;40% among survivors of OHCA \u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. This large variation is largely due to the lack of standardized assessments and data on optimal timing for screening. Most previous studies had enrolled a relatively small number of patients because traditional tools for neuropsychologic examination are time-consuming and need expertized personnel for individual tests \u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. The rapid expansion of remotely administered screening tools for cognitive impairment and mood disorders, which are increasingly becoming necessary in clinical settings, has far-reaching applications for patient follow-up and monitoring. In the present study, we used the T-mMoCA test and AD-8, which have been developed and validated for patients with Alzheimer\u0026rsquo;s disease. The incidence of cognitive impairment (23.7%) and emotional disorders (28.9%) 6 months after the cardiac arrest is consistent with that of previous studies \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. Accordingly, this implied that the telephone version of T-mMoCA and AD-8 for cognitive impairment and PHQ-9 and HADS for mood disorders are feasible screening tools in OHCA survivors for long-term follow-up.\u003c/p\u003e \u003cp\u003eAlthough a substantial portion of cognitive improvement occurs in the first 3 months following cardiac arrest, health-related QoL can only be adequately assessed when the patient is allowed to interact with their social environment \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. Hence, we evaluated cognitive and mood impairments in neurologically intact survivors during the 6-month follow-up; however, the optimal timing of function evaluation in postcardiac arrest survivors still remains unknown. Serial evaluation of cognitive and mood impairment starting from 3 months after the cardiac arrest will be more sensitive for impairment detection, and further studies are needed to confirm this. It is interesting to observe that Sandroni et al. found that women are less likely than men to achieve a good QoL after cardiac arrest \u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. However, our results showed no sex differences in the development of cognitive impairment and emotional disorders.\u003c/p\u003e \u003cp\u003eIn the logistic regression analysis, cognitive impairment and mood disorders were independent risk factors for one another. Previous neuropsychological studies revealed that cognition and emotion often interact \u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e, and among the various domains of cognitive function, memory and recall were largely influenced by the patient\u0026rsquo;s emotional state \u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. Therefore, cognitive dysfunction and mood disorders may share a majority of symptoms, making it difficult to distinguish them. Our study also demonstrated that most of the patients experienced both conditions simultaneously, and that they were not mutually exclusive. This may be the result of the fact that hypoxic brain injury involves various brain regions at the same time, including the prefrontal cortex, subcortical regions, temporal lobes, and hippocampus. Damage to these areas influences not only memory and executive functions, but also depressive states. Moreover, one deficit could lead to another deficit. For example, patients with cognitive dysfunction may be more likely to develop depressive episodes than patients without it. Similarly, depression might be associated with an increased risk of cognitive disturbance occurrence. However, because of the present study\u0026rsquo;s retrospective design, we could not confirm the causality of each condition.\u003c/p\u003e \u003cp\u003eOur study had several limitations. First, although this was the first investigation to reveal the incidence of cognitive impairment and mood disorders among survivors of OHCA in South Korea, its results cannot be generalized to other environments as it was conducted in a single, urban hospital. Second, we did not have the baseline cognitive function and mood status before OHCA; thus, we assumed that all impairments were attributable to OHCA. Finally, hidden confounders, such as education level, financial status, and familiar support, could affect the occurrence of cognitive dysfunction and mood disorders.\u003c/p\u003e \u003cp\u003eIn OHCA survivors with favorable neurologic outcomes at 6 months postcardiac arrest, 23.7% had cognitive impairment, and 28.9% had emotional disorders, as determined by telephone-based evaluation. Furthermore, both the conditions were associated with a low QoL, necessitating appropriate screening and active intervention. In view of the wide variations regarding impairment incidence and the absence of standard assessment tools for postcardiac arrest survivors in contemporary clinical practice, our telephone-based evaluation will be a convenient and simple tool.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and participants\u003c/h2\u003e \u003cp\u003eThis was a retrospective, cross-sectional, single-center study conducted at a urban, tertiary hospital located in Seoul, with nearly 400 OHCA cases and 120,000 adult patients annually admitted to the emergency department (ED). Our hospital has prospectively registered comatose survival since 2012, not only for patient monitoring and improving outcomes, but for systemic research as well \u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. The inclusion criteria were patients who underwent targeted temperature treatment. Pediatric patients (\u0026lt;\u0026thinsp;19 years old), those with trauma, terminal illnesses, do-not-resuscitate order, those who refused target temperature management or intensive care unit care admission, or were transferred due to the lack of room for admission were excluded from this registry.\u003c/p\u003e \u003cp\u003eThe registry included epidemiological and clinical data, such as prehospital data, ED resuscitation according to Utstein guidelines, and postcardiac arrest syndrome care-related factors \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. The clinical outcomes also included duration of hospital stay, survival discharge, and neurologic outcomes. Neurologic outcomes were evaluated with CPC at discharge by emergency medicine physicians on duty and 6 months later by physicians using a telephone-based method.\u003c/p\u003e \u003cp\u003eAmong previously enrolled patients on the registry, we extracted patients those who had favorable neurologic outcomes (i.e., CPC 1 or 2) at both discharge and the 6-month follow-up between 2012 and 2021. We thoroughly explained the study design to the patients and obtained informed consent using the telephone. Patients were excluded if they refused to participate in the study and did not have the necessary spoken language skills. This study was approved by the Institutional Review Board of the Asan Medical Center (study no. 2021\u0026thinsp;\u0026minus;\u0026thinsp;1170). All methods were performed in accordance with the relevant guidelines and regulations.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cp\u003eExperienced emergency physicians (K.J.S. and K.Y.J.) interviewed the participants through telephone and in-person assessments to screen cognitive and mood disorders. The T-mMoCA assesses digit numbering, attention, calculation, repetition, fluency, abstraction, delayed recall, and orientation and, excluding the visual tests, has a maximum score of 22 points \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. The AD-8 is an 8-item questionnaire that evaluates memory, orientation, executive functioning, and interest in activities with a total score of 8 points (i.e., yes or no answers for each question) \u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. The PHQ-9 is a self-rating questionnaire consisting of nine items in accordance with the Diagnostic and Statistical Manual of Mental Disorder. Responders score each item from 0\u0026ndash;3 based on the frequency of their experience over their past 2-week period (not at all, several days, more than half the days, or nearly every day), with a maximum score of 27 points \u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. The HADS rating scale is compounded of 14 items, 7 of which are related to anxiety and 7 to depression \u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. Each of the items is scored on a 4-point scale from 0\u0026ndash;3, with the final score ranging between 0\u0026ndash;21. Cut-off values for each screening assessment are based on previous research and are presented in Supplementary Table \u003cspan refid=\"MOESM1\" class=\"InternalRef\"\u003eS1\u003c/span\u003e. QoL was measured with the European Quality of Life 5-Dimension 5-Levels questionnaire (EQ-5D-5L) and visual analogue scale (EQ-VAS). The EQ-5D-5L is scored on a 5-point (a smaller score indicated a more positive outcome) and combined to form a 5-digit score, which is then converted into a EQ utility index based on set values obtained from a reference population \u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eWe extracted demographic data, including age, sex, and comorbidities, from the registry. Arrhythmia included any underlying arrhythmia that required treatment, such as medication, implantable cardioverter defibrillator, pacemaker, or catheter ablation, before cardiac arrest. Malignancy was defined as active cancer confirmed through histologic or cytological before cardiac arrest or recurrent or metastatic cancer not in complete remission from a hematologic malignancy. Furthermore, prehospital and ED resuscitation-related factors were extracted according to the Utstein guidelines. Presumed causes of cardiac arrest were recorded by physicians on duty and divided into two categories (i.e., cardiac and other medical). Postcardiac arrest care-related data and clinical outcomes, such as percutaneous cardiac intervention, extracorporeal corporeal membrane oxygenation, duration of intensive care unit stay, and duration of hospital stay, were collected from electronic medical records.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eDescriptive analyses were conducted to compare baseline characteristics with respect to cognitive impairment and mood disorders. Categorical variables were presented as percentages and were analyzed using chi-square tests; meanwhile, non-normally distributed continuous variables were represented as medians with interquartile ranges and were compared using the Mann\u0026ndash;Whitney U tests. Independent risk factors for the occurrence of each condition were determined by backward step-wise multivariate logistic regression analyses with statistically significant variables (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.1) from the univariate analysis. All statistical analyses were performed using SPSS version 21.0 (IBM Corp., Armonk, NY, USA), with \u003cem\u003eP\u003c/em\u003e values\u0026thinsp;\u0026lt;\u0026thinsp;0.05 considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJ.S.K. designed study, analyzed data, and wrote the manuscript. Y.J.K. contributed to analyzing the data and preparing figures. S.M.R, and S.A. collected data and revised the manuscript. W.Y.K. supervised and provided review of the draft. All authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets of this study can be obtained from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by 2021 science research program through the Korean Association of Cardiopulmonary Resuscitation (KACPR) (No. 2021-004)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eYan, S. \u003cem\u003eet al.\u003c/em\u003e The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis. Crit Care 24, 61 (2020).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChin, Y. H. \u003cem\u003eet al.\u003c/em\u003e Long-term outcomes after out-of-hospital cardiac arrest: A systematic review and meta-analysis. Resuscitation 171, 15\u0026ndash;29 (2022).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWimmer, H. \u003cem\u003eet al.\u003c/em\u003e Health-related quality of life after out-of-hospital cardiac arrest \u0026ndash; a five-year follow-up studyJūratė Šaltytė Benth. Resuscitation 162, 372\u0026ndash;380 (2021).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLilja, G. \u003cem\u003eet al.\u003c/em\u003e Cognitive function in survivors of out-of-hospital cardiac arrest after target temperature management at 33\u0026deg;C versus 36\u0026deg;C. Circulation 131, 1340\u0026ndash;1349 (2015).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLilja, G. \u003cem\u003eet al.\u003c/em\u003e Anxiety and depression among out-of-hospital cardiac arrest survivors. Resuscitation 97, 68\u0026ndash;75 (2015).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAndrew, E., Nehme, Z., Bernard, S. \u0026amp; Smith, K. Comparison of health-related quality of life and functional recovery measurement tools in out-of-hospital cardiac arrest survivors. Resuscitation 107, 57\u0026ndash;64 (2016).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLilja, G. \u003cem\u003eet al.\u003c/em\u003e Return to work and participation in society after out-of-hospital cardiac arrest. Circulation Cardiovasc Qual Outcomes 11, e003566 (2018).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePanchal, A. R. \u003cem\u003eet al.\u003c/em\u003e Part 3: Adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 142, S366\u0026ndash;S468 (2020).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNolan, J. P. \u003cem\u003eet al.\u003c/em\u003e European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-resuscitation care. Resuscitation 161, 220\u0026ndash;269 (2021).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOverton, E. T. \u003cem\u003eet al.\u003c/em\u003e The Alzheimer\u0026rsquo;s disease-8 and Montreal Cognitive Assessment as screening tools for neurocognitive impairment in HIV-infected persons. J Neurovirol 19, 109\u0026ndash;116 (2013).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHansson, M., Chotai, J., Nordst\u0026ouml;m, A. \u0026amp; Bodlund, O. Comparison of two self-rating scales to detect depression: HADS and PHQ-9. Br J Gen Pract 59, e283\u0026ndash;e288 (2009).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSabedra, A. R. \u003cem\u003eet al.\u003c/em\u003e Neurocognitive outcomes following successful resuscitation from cardiac arrest. Resuscitation 90, 67\u0026ndash;72 (2015).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZook, N. \u003cem\u003eet al.\u003c/em\u003e Neurocognitive function following out-of-hospital cardiac arrest: A systematic review. Resuscitation 170, 238\u0026ndash;246 (2022).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoulaert, V. R. M. P., Verbunt, J. A., Heugten, C. M. van \u0026amp; Wade, D. T. Cognitive impairments in survivors of out-of-hospital cardiac arrest: A systematic review. Resuscitation 80, 297\u0026ndash;305 (2009).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCronberg, T., Lilja, G., Rundgren, M., Friberg, H. \u0026amp; Widner, H. Long-term neurological outcome after cardiac arrest and therapeutic hypothermia. Resuscitation 80, 1119\u0026ndash;1123 (2009).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLundgren-Nilsson, \u0026Aring;., Ros\u0026eacute;n, H., Hofgren, C. \u0026amp; Sunnerhagen, K. S. The first year after successful cardiac resuscitation: Function, activity, participation and quality of life. Resuscitation 66, 285\u0026ndash;289 (2005).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDuits, A., Munnecom, T., Heugten, C. van \u0026amp; Oostenbrugge, R. J. van. Cognitive complaints in the early phase after stroke are not indicative of cognitive impairment. J Neurology Neurosurg Psychiatry 79, 143 (2008).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSteinbusch, C. V. M., Heugten, C. M. van, Rasquin, S. M. C., Verbunt, J. A. \u0026amp; Moulaert, V. R. M. Cognitive impairments and subjective cognitive complaints after survival of cardiac arrest: A prospective longitudinal cohort study. Resuscitation 120, 132\u0026ndash;137 (2017).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLazzarin, T. \u003cem\u003eet al.\u003c/em\u003e Post-Cardiac Arrest: Mechanisms, Management, and Future Perspectives. J Clin Medicine 12, 259 (2022).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSandroni, C., Cronberg, T. \u0026amp; Sekhon, M. Brain injury after cardiac arrest: pathophysiology, treatment, and prognosis. Intensive Care Med 47, 1393\u0026ndash;1414 (2021).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZlatar, Z. Z., Moore, R. C., Palmer, B. W., Thompson, W. K. \u0026amp; Jeste, D. V. Cognitive complaints correlate with depression rather than concurrent objective cognitive impairment in the successful aging evaluation baseline sample. J Geriatr Psych Neur 27, 181\u0026ndash;187 (2013).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLanga, K. M. \u0026amp; Levine, D. A. The diagnosis and management of mild cognitive impairment: A clinical review. Jama 312, 2551\u0026ndash;2561 (2014).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim, J. \u003cem\u003eet al.\u003c/em\u003e Impact of lung compliance on neurological outcome in patients with acute respiratory distress syndrome following out-of-hospital cardiac arrest. J Clin Medicine 9, 527 (2020).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIdris, A. H. \u003cem\u003eet al.\u003c/em\u003e 2015 Revised Utstein-Style Recommended Guidelines for Uniform Reporting of Data From Drowning-Related Resuscitation: An ILCOR Advisory Statement. \u003cem\u003eCirculation Cardiovasc Qual Outcomes\u003c/em\u003e 10, e000024 (2018).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWong, A. \u003cem\u003eet al.\u003c/em\u003e The Montreal Cognitive Assessment 5-minute protocol is a brief, valid, reliable, and feasible cognitive screen for telephone administration. Stroke 46, 1059\u0026ndash;1064 (2015).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGalvin, J. E. \u003cem\u003eet al.\u003c/em\u003e The AD8. Neurology 65, 559\u0026ndash;564 (2005).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKurt, K., L, S. R. \u0026amp; W, W. J. B. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 9, 606\u0026ndash;613 (2001).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBjelland, I., Dahl, A. A., Haug, T. T. \u0026amp; Neckelmann, D. The validity of the Hospital Anxiety and Depression Scale An updated literature review. J Psychosom Res 52, 69\u0026ndash;77 (2002).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHerdman, M. \u003cem\u003eet al.\u003c/em\u003e Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 20, 1727\u0026ndash;1736 (2011).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"out-of-hospital cardiac arrest, cognitive impairment, mood disorder, quality of life","lastPublishedDoi":"10.21203/rs.3.rs-2679692/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2679692/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study determined the incidence of the cognitive impairments and mood disorders by telephone-based evaluation using previously mentioned scoring systems in out-of-hospital cardiac arrest (OHCA) survival with good neurologic outcome. Retrospective, cross-sectional, single-center study was performed, and a total of 97 patients were analyzed. Telephone version of Montreal Cognitive Assessment, Alzheimer\u0026rsquo;s disease-8 were used for evaluating cognitive dysfunctions, and the Patient Health Questionnaire-9 and the Hospital Anxiety and Depression Scale were used for assessing mood disorders. Quality of life was measured with the European Quality of Life 5-Dimension 5-Levels questionnaire. About one fourth patients experienced cognitive impairments (n\u0026thinsp;=\u0026thinsp;23, 23.7%) or mood disorders (n\u0026thinsp;=\u0026thinsp;28, 28.9%). Combined mood disorders (adjusted OR 21.36, 95% CI 5.14\u0026ndash;88.84) and hospital length of stay (adjusted OR 1.04, 95% CI 1.01\u0026ndash;1.08) were independent risk factors. In case of mood disorders, combined cognitive impairments (adjusted OR 9.94, 95% CI 2.83\u0026ndash;35.97) and non-cardiac cause of cardiac arrest (adjusted OR 11.51, 95% CI 3.15\u0026ndash;42.15) were risk factors. Furthermore, the quality of life was significantly low in the group with both cognitive impairments and mood disorders. Cognitive impairments and mood disorders were common among patients with good neurologic recovery.\u003c/p\u003e","manuscriptTitle":"Telephone-based evaluation of cognitive impairment and mood disorders among out-of- hospital cardiac arrest survivors with good neurologic outcome: a retrospective cohort study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-03-21 15:44:09","doi":"10.21203/rs.3.rs-2679692/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2023-08-03T06:31:42+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-08-02T11:43:31+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"73d350bf-3809-4935-831a-03d0aa2c00fd","date":"2023-07-28T08:53:19+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-07-22T16:44:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"360df63b-07c6-4ce0-bd30-84c885358173","date":"2023-07-13T08:46:07+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-07-12T11:11:54+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-06-29T14:56:34+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2023-03-18T11:31:53+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-03-18T11:18:16+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2023-03-11T01:20:39+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d559ccef-78e6-4b57-8e66-5399dcc74a1f","owner":[],"postedDate":"March 21st, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":20021225,"name":"Health sciences/Medical research/Outcomes research"},{"id":20021226,"name":"Health sciences/Medical research/Epidemiology"}],"tags":[],"updatedAt":"2023-10-30T15:04:46+00:00","versionOfRecord":{"articleIdentity":"rs-2679692","link":"https://doi.org/10.1038/s41598-023-44963-1","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2023-10-23 15:02:17","publishedOnDateReadable":"October 23rd, 2023"},"versionCreatedAt":"2023-03-21 15:44:09","video":"","vorDoi":"10.1038/s41598-023-44963-1","vorDoiUrl":"https://doi.org/10.1038/s41598-023-44963-1","workflowStages":[]},"version":"v1","identity":"rs-2679692","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2679692","identity":"rs-2679692","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}