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Joshi VL, Borregaard B, Mikkelsen TB, Tang LH, Nordström EB, Bruvik SM, Wieghorst A, Zwisler AD, Wagner MK. Observer-reported cognitive decline in out-of-hospital cardiac arrest survivors and its association with long-term survivor and relative outcomes. Resuscitation 2024; 197:110162. [PMID: 38452993 DOI: 10.1016/j.resuscitation.2024.110162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/04/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
AIM Long-term cognitive decline after out-of-hospital cardiac arrest (OHCA) is still poorly understood. This study describes long-term observer-reported cognitive decline among Danish OHCA survivors, including differences in years since the event, and investigates characteristics and self-reported outcomes associated with observer-reported cognitive decline. METHODS Adults who survived an OHCA from 2016 to 2019, and their relatives, completed the national DANish Cardiac Arrest Survivorship survey. Relatives completed the Informant Questionnaire on Cognitive Decline in the Elderly, Cardiac Arrest version (IQCODE-CA), the Hospital Anxiety and Depression Scale (HADS) and the World Health Organisation-Five Well-being index; and survivors completed the Two Simple Questions (everyday activities and mental recovery), the Modified Fatigue Impact Scale, HADS, and the Short World Health Organisation Disability Assessment Schedule 2.0. Potential associations between survivor characteristics and the IQCODE-CA were investigated using a multivariable logistic regression model. Self-reported outcomes among survivors and relatives, and the association with IQCODE-CA scores were investigated using separate logistic regression models. RESULTS Total median IQCODE-CA score was 3.04 (IQR: 3.00-3.27), with 47% having possible cognitive decline (score ≥ 3.04), consistent across time groups. Increasing age (OR 0.98, 95% CI: 0.97-0.99) and worse self-reported mental and physical outcomes for survivors and relatives, except 'everyday activities' were significantly associated with possible cognitive decline among survivors. CONCLUSIONS Nearly half of OHCA survivors may suffer long-term cognitive decline. Worse self-reported mental and physical outcomes among survivors and their relatives are associated with potential cognitive decline emphasising the need for post-OHCA care to include systematic neurocognitive assessment, tailored support and effective rehabilitation.
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Affiliation(s)
- Vicky L Joshi
- Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark.
| | - Britt Borregaard
- Department of Clinical Research, University of Southern Denmark Odense, Denmark; Department of Cardiology, Odense University Hospital, Odense, Denmark; Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
| | - Tina Broby Mikkelsen
- Department of Clinical Research, University of Southern Denmark Odense, Denmark; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Lars H Tang
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals & The Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Erik Blennow Nordström
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics), Skåne University Hospital, Sweden
| | | | - Anders Wieghorst
- Department of Clinical Research, University of Southern Denmark Odense, Denmark; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark; Department of Psychology, University of Southern Denmark, Odense, Denmark; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ann-Dorthe Zwisler
- Department of Clinical Research, University of Southern Denmark Odense, Denmark; REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Mette Kirstine Wagner
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Heimburg K, Lilja G, Blennow Nordström E, Friberg H, Gregersen Oestergaard L, Grejs AM, Keeble TR, Mion M, Nielsen N, Rylander C, Segerström M, Thomsen IK, Ullén S, Undén J, Wise MP, Cronberg T, Tornberg ÅB. Agreement between self-reported and objectively assessed physical activity among out-of-hospital cardiac arrest survivors. Clin Physiol Funct Imaging 2024; 44:144-153. [PMID: 37830144 DOI: 10.1111/cpf.12860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/04/2023] [Accepted: 10/11/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Low level of physical activity is a risk factor for new cardiac events in out-of-hospital cardiac arrest (OHCA) survivors. Physical activity can be assessed by self-reporting or objectively by accelerometery. AIM To investigate the agreement between self-reported and objectively assessed physical activity among OHCA survivors HYPOTHESIS: Self-reported levels of physical activity will show moderate agreement with objectively assessed levels of physical activity. METHOD Cross-sectional study including OHCA survivors in Sweden, Denmark, and the United Kingdom. Two questions about moderate and vigorous intensity physical activity during the last week were used as self-reports. Moderate and vigorous intensity physical activity were objectively assessed with accelerometers (ActiGraph GT3X-BT) worn upon the right hip for 7 consecutive days. RESULTS Forty-nine of 106 OHCA survivors answered the two questions for self-reporting and had 7 valid days of accelerometer assessment. More physically active days were registered by self-report compared with accelerometery for both moderate intensity (median 5 [3:7] vs. 3 [0:5] days; p < 0.001) and vigorous intensity (1 [0:3] vs. 0 [0:0] days; p < 0.001). Correlations between self-reported and accelerometer assessed physical activity were sufficient (moderate intensity: rs = 0.336, p = 0.018; vigorous intensity: rs = 0.375, p = 0.008), and agreements were fair and none to slight (moderate intensity: k = 0.269, p = 0.001; vigorous intensity: k = 0.148, p = 0.015). The categorization of self-reported versus objectively assessed physical activity showed that 26% versus 65% had a low level of physical activity. CONCLUSION OHCA survivors reported more physically active days compared with the results of the accelerometer assessment and correlated sufficiently and agreed fairly and none to slightly.
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Affiliation(s)
- Katarina Heimburg
- Neurology, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Gisela Lilja
- Neurology, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Erik Blennow Nordström
- Neurology, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Hans Friberg
- Intensive and Perioperative Care, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Malmö, Sweden
| | - Lisa Gregersen Oestergaard
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Anders M Grejs
- Department of Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas R Keeble
- Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon, UK
- Anglia Ruskin School of Medicine, Medical Technology Research Center, Chelmsford, UK
| | - Marco Mion
- Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon, UK
| | - Niklas Nielsen
- Anaesthesiology and Intensive Care, Department of Clinical Sciences Lund, Helsingborg Hospital, Lund University, Lund, Sweden
| | - Christian Rylander
- Anaesthesiology and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Magnus Segerström
- Department of Neurology and Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ida Katrine Thomsen
- Department of Clinical Medicine, Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
| | - Susann Ullén
- Clinical Studies Sweden - Forum South, Skane University Hospital, Lund, Sweden
| | - Johan Undén
- Anaesthesiology and Intensive Care Medicine, Department of Clinical Sciences Malmö, Skane University Hospital, Lund University, Lund, Sweden
- Operation and Intensive Care, Hallands Hospital Halmstad, Halmstad, Sweden
| | - Matthew P Wise
- Adult Critical Care, University Hospital of Wales, Cardiff, UK
| | - Tobias Cronberg
- Neurology, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Åsa B Tornberg
- Department of Health Sciences, Lund University, Lund, Sweden
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3
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Lilja G, Ullén S, Dankiewicz J, Friberg H, Levin H, Nordström EB, Heimburg K, Jakobsen JC, Ahlqvist M, Bass F, Belohlavek J, Olsen RB, Cariou A, Eastwood G, Fanebust HR, Grejs AM, Grimmer L, Hammond NE, Hovdenes J, Hrecko J, Iten M, Johansen H, Keeble TR, Kirkegaard H, Lascarrou JB, Leithner C, Lesona ME, Levis A, Mion M, Moseby-Knappe M, Navarra L, Nordberg P, Pelosi P, Quayle R, Rylander C, Sandberg H, Saxena M, Schrag C, Siranec M, Tiziano C, Vignon P, Wendel-Garcia PD, Wise MP, Wright K, Nielsen N, Cronberg T. Effects of Hypothermia vs Normothermia on Societal Participation and Cognitive Function at 6 Months in Survivors After Out-of-Hospital Cardiac Arrest: A Predefined Analysis of the TTM2 Randomized Clinical Trial. JAMA Neurol 2023; 80:1070-1079. [PMID: 37548968 PMCID: PMC10407762 DOI: 10.1001/jamaneurol.2023.2536] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 05/25/2023] [Indexed: 08/08/2023]
Abstract
Importance The Targeted Hypothermia vs Targeted Normothermia After Out-of-Hospital Cardiac Arrest (TTM2) trial reported no difference in mortality or poor functional outcome at 6 months after out-of-hospital cardiac arrest (OHCA). This predefined exploratory analysis provides more detailed estimation of brain dysfunction for the comparison of the 2 intervention regimens. Objectives To investigate the effects of targeted hypothermia vs targeted normothermia on functional outcome with focus on societal participation and cognitive function in survivors 6 months after OHCA. Design, Setting, and Participants This study is a predefined analysis of an international multicenter, randomized clinical trial that took place from November 2017 to January 2020 and included participants at 61 hospitals in 14 countries. A structured follow-up for survivors performed at 6 months was by masked outcome assessors. The last follow-up took place in October 2020. Participants included 1861 adult (older than 18 years) patients with OHCA who were comatose at hospital admission. At 6 months, 939 of 1861 were alive and invited to a follow-up, of which 103 of 939 declined or were missing. Interventions Randomization 1:1 to temperature control with targeted hypothermia at 33 °C or targeted normothermia and early treatment of fever (37.8 °C or higher). Main outcomes and measures Functional outcome focusing on societal participation assessed by the Glasgow Outcome Scale Extended ([GOSE] 1 to 8) and cognitive function assessed by the Montreal Cognitive Assessment ([MoCA] 0 to 30) and the Symbol Digit Modalities Test ([SDMT] z scores). Higher scores represent better outcomes. Results At 6 months, 836 of 939 survivors with a mean age of 60 (SD, 13) (range, 18 to 88) years (700 of 836 male [84%]) participated in the follow-up. There were no differences between the 2 intervention groups in functional outcome focusing on societal participation (GOSE score, odds ratio, 0.91; 95% CI, 0.71-1.17; P = .46) or in cognitive function by MoCA (mean difference, 0.36; 95% CI,-0.33 to 1.05; P = .37) and SDMT (mean difference, 0.06; 95% CI,-0.16 to 0.27; P = .62). Limitations in societal participation (GOSE score less than 7) were common regardless of intervention (hypothermia, 178 of 415 [43%]; normothermia, 168 of 419 [40%]). Cognitive impairment was identified in 353 of 599 survivors (59%). Conclusions In this predefined analysis of comatose patients after OHCA, hypothermia did not lead to better functional outcome assessed with a focus on societal participation and cognitive function than management with normothermia. At 6 months, many survivors had not regained their pre-arrest activities and roles, and mild cognitive dysfunction was common. Trial Registration ClinicalTrials.gov Identifier: NCT02908308.
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Affiliation(s)
- Gisela Lilja
- Clinical Studies Sweden, Forum South, Skane University Hospital, Lund, Sweden
| | - Susann Ullén
- Clinical Studies Sweden, Forum South, Skane University Hospital, Lund, Sweden
| | - Josef Dankiewicz
- Cardiology, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
| | - Hans Friberg
- Anesthesia and Intensive Care, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Malmö, Sweden
| | - Helena Levin
- Anesthesia and Intensive Care, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Malmö, Sweden
| | - Erik Blennow Nordström
- Neurology, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
| | - Katarina Heimburg
- Neurology, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
| | - Janus Christian Jakobsen
- Copenhagen Trial Unit, Center for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Denmark
| | - Marita Ahlqvist
- Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Frances Bass
- Critical Care Program, The George Institute for Global Health and UNSW Sydney, Sydney, New South Wales, Australia
- Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Jan Belohlavek
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
| | | | - Alain Cariou
- Cochin University Hospital (APHP) and Paris Cité University (medical school), Paris, France
| | - Glenn Eastwood
- Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia
| | - Hans Rune Fanebust
- Cardiac Intensive Care Unit, Haukeland University Hospital, Bergen, Norway
| | - Anders M. Grejs
- Department of Intensive Care Medicine and Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lisa Grimmer
- University Hospitals Bristol and Weston NHS Trust, Bristol, United Kingdom
| | - Naomi E. Hammond
- Critical Care Program, The George Institute for Global Health and UNSW Sydney, Sydney, New South Wales, Australia
- Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Jan Hovdenes
- Department of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Juraj Hrecko
- The 1st Department of Internal Medicine, Cardioangiology, Medical Faculty of Charles University in Hradec Králové and University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Manuela Iten
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Henriette Johansen
- Department of Neurology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Thomas R. Keeble
- Essex Cardio Thoracic Centre, Basildon, Essex, UK Thurrock University Hospitals, Basildon, United Kingdom
- MTRC, Anglia Ruskin University Faculty of Health Education Medicine & Social Care, Chelmsford, Essex, United Kingdom
| | - Hans Kirkegaard
- Research Center for Emergency Medicine, Emergency Department Aarhus University Hospital and Department of Clinical Medicine Aarhus University, Aarhus, Denmark
| | | | - Christoph Leithner
- Charité- Universitätsmedizin Berlin, coroporate member of Freie Universität Berlin and Humboldt- Universität-zu-Berlin, Department of Neurology, Berlin, Germany
| | | | - Anja Levis
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marco Mion
- Essex Cardio Thoracic Centre, Basildon, Essex, UK Thurrock University Hospitals, Basildon, United Kingdom
- MTRC, Anglia Ruskin University Faculty of Health Education Medicine & Social Care, Chelmsford, Essex, United Kingdom
| | - Marion Moseby-Knappe
- Neurology, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
| | - Leanlove Navarra
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Per Nordberg
- Center for Resuscitation Sciences, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Paolo Pelosi
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
- Anesthesia and Critical Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Rachael Quayle
- Manchester Foundation Trust, Manchester, United Kingdom
- The Greater Manchester NIHR Clinical Research Network, Manchester, United Kingdom
| | - Christian Rylander
- Department of Surgical Sciences, Anaesthesiology and Intensive Care Medicine, Uppsala University, Sweden
| | | | - Manoj Saxena
- St George Hospital Clinical School, The George institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Claudia Schrag
- Intensive Care Department, Kantonspital St Gallen, St Gallen, Switzerland
| | - Michal Siranec
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
| | - Cassina Tiziano
- Cardiac anesthesia and Intensive Care department, Istituto Cardiocentro Ticino, Lugano, Switzerland
| | - Philippe Vignon
- Medical-surgical ICU and Inserm CIC 1435, Dupuytren University hospital, Limoges, France
| | | | - Matt P. Wise
- Adult Critical Care, University Hospital of Wales, Cardiff, United Kingdom
| | - Kim Wright
- University Hospitals Bristol and Weston NHS Trust, Bristol, United Kingdom
| | - Niklas Nielsen
- Department of Clinical Sciences Lund, Anaesthesia and Intensive Care and Clinical Sciences Helsingborg, Helsingborg Hospital, Lund University, Lund, Sweden
| | - Tobias Cronberg
- Neurology, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
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4
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Blennow Nordström E, Vestberg S, Evald L, Mion M, Segerström M, Ullén S, Bro-Jeppesen J, Friberg H, Heimburg K, Grejs AM, Keeble TR, Kirkegaard H, Ljung H, Rose S, Wise MP, Rylander C, Undén J, Nielsen N, Cronberg T, Lilja G. Neuropsychological outcome after cardiac arrest: results from a sub-study of the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (TTM2) trial. Crit Care 2023; 27:328. [PMID: 37633944 PMCID: PMC10463667 DOI: 10.1186/s13054-023-04617-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Cognitive impairment is common following out-of-hospital cardiac arrest (OHCA), but the nature of the impairment is poorly understood. Our objective was to describe cognitive impairment in OHCA survivors, with the hypothesis that OHCA survivors would perform significantly worse on neuropsychological tests of cognition than controls with acute myocardial infarction (MI). Another aim was to investigate the relationship between cognitive performance and the associated factors of emotional problems, fatigue, insomnia, and cardiovascular risk factors following OHCA. METHODS This was a prospective case-control sub-study of The Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial. Eight of 61 TTM2-sites in Sweden, Denmark, and the United Kingdom included adults with OHCA of presumed cardiac or unknown cause. A matched non-arrest control group with acute MI was recruited. At approximately 7 months post-event, we administered an extensive neuropsychological test battery and questionnaires on anxiety, depression, fatigue, and insomnia, and collected information on the cardiovascular risk factors hypertension and diabetes. RESULTS Of 184 eligible OHCA survivors, 108 were included, with 92 MI controls enrolled. Amongst OHCA survivors, 29% performed z-score ≤ - 1 (at least borderline-mild impairment) in ≥ 2 cognitive domains, 14% performed z-score ≤ - 2 (major impairment) in ≥ 1 cognitive domain while 54% performed without impairment in any domain. Impairment was most pronounced in episodic memory, executive functions, and processing speed. OHCA survivors performed significantly worse than MI controls in episodic memory (mean difference, MD = - 0.37, 95% confidence intervals [- 0.61, - 0.12]), verbal (MD = - 0.34 [- 0.62, - 0.07]), and visual/constructive functions (MD = - 0.26 [- 0.47, - 0.04]) on linear regressions adjusted for educational attainment and sex. When additionally adjusting for anxiety, depression, fatigue, insomnia, hypertension, and diabetes, executive functions (MD = - 0.44 [- 0.82, - 0.06]) were also worse following OHCA. Diabetes, symptoms of anxiety, depression, and fatigue were significantly associated with worse cognitive performance. CONCLUSIONS In our study population, cognitive impairment was generally mild following OHCA. OHCA survivors performed worse than MI controls in 3 of 6 domains. These results support current guidelines that a post-OHCA follow-up service should screen for cognitive impairment, emotional problems, and fatigue. TRIAL REGISTRATION ClinicalTrials.gov, NCT03543371. Registered 1 June 2018.
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Affiliation(s)
- Erik Blennow Nordström
- Neurology, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden.
| | | | - Lars Evald
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
| | - Marco Mion
- Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon, UK
- Medical Technology Research Centre, Anglia Ruskin School of Medicine, Chelmsford, UK
| | - Magnus Segerström
- Department of Neurology and Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Susann Ullén
- Clinical Studies Sweden - Forum South, Skane University Hospital, Lund, Sweden
| | - John Bro-Jeppesen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Friberg
- Intensive and Perioperative Care, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Malmö, Sweden
| | - Katarina Heimburg
- Neurology, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Anders M Grejs
- Department of Intensive Care Medicine and Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Thomas R Keeble
- Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon, UK
- Medical Technology Research Centre, Anglia Ruskin School of Medicine, Chelmsford, UK
| | - Hans Kirkegaard
- Research Centre for Emergency Medicine, Emergency Department and Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Hanna Ljung
- Neurology, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Sofia Rose
- Clinical Psychology, Cardiff and Vale University Health Board, NHS Wales, Cardiff, UK
| | - Matthew P Wise
- Adult Critical Care, University Hospital of Wales, Cardiff, UK
| | - Christian Rylander
- Anaesthesiology and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Johan Undén
- Intensive and Perioperative Care, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Malmö, Sweden
- Operation and Intensive Care, Hallands Hospital Halmstad, Halmstad, Sweden
| | - Niklas Nielsen
- Anesthesiology and Intensive Care, Department of Clinical Sciences Lund, Helsingborg Hospital, Lund University, Lund, Sweden
| | - Tobias Cronberg
- Neurology, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
| | - Gisela Lilja
- Neurology, Department of Clinical Sciences Lund, Skane University Hospital, Lund University, Lund, Sweden
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5
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Blennow Nordström E, Lilja G, Ullén S, Blennow K, Friberg H, Hassager C, Kjærgaard J, Mattsson-Carlgren N, Moseby-Knappe M, Nielsen N, Vestberg S, Zetterberg H, Cronberg T. Serum neurofilament light levels are correlated to long-term neurocognitive outcome measures after cardiac arrest. Brain Inj 2022; 36:800-809. [DOI: 10.1080/02699052.2022.2048693] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Erik Blennow Nordström
- Department of Clinical Sciences Lund, Neurology, Lund University, Skane University Hospital, Lund, Sweden
| | - Gisela Lilja
- Department of Clinical Sciences Lund, Neurology, Lund University, Skane University Hospital, Lund, Sweden
| | - Susann Ullén
- Clinical Studies Sweden – Forum South, Skane University Hospital, Lund, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Hans Friberg
- Department of Clinical Sciences Lund, Intensive and Perioperative Care, Lund University, Skane University Hospital, Malmö, Sweden
| | - Christian Hassager
- Department of Cardiology, Rigshospitalet and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Kjærgaard
- Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Marion Moseby-Knappe
- Department of Clinical Sciences Lund, Neurology, Lund University, Skane University Hospital, Lund, Sweden
| | - Niklas Nielsen
- Department of Clinical Sciences Lund, Anesthesiology and Intensive Care, Lund University, Helsingborg Hospital, Lund, Sweden
| | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Tobias Cronberg
- Department of Clinical Sciences Lund, Neurology, Lund University, Skane University Hospital, Lund, Sweden
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Zook N, Voss S, Blennow Nordström E, Brett SJ, Jenkinson E, Shaw P, White P, Benger J. Neurocognitive function following out-of-hospital cardiac arrest: A systematic review. Resuscitation 2021; 170:238-246. [PMID: 34648921 DOI: 10.1016/j.resuscitation.2021.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/28/2021] [Accepted: 10/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The primary aim of this review was to investigate neurocognitive outcomes following out-of-hospital cardiac arrest (OHCA). Specifically, the focus was on identifying the different neurocognitive domains that are assessed, the measures used, and the level of, and criteria for, impairment. DESIGN AND REVIEW METHODS A systematic review of the literature from 2006 to 2021 was completed using Medline, Cinahl and Psychinfo. Criteria for inclusion were studies with participants over the age of 18, OHCA and at least one neurocognitive function measure. Qualitative and case studies were excluded. Reviewers assessed criteria and risk of bias using a modified version of Downs and Black. RESULTS Forty-three studies were identified. Most studies had a low risk of bias (n = 31) or moderate risk of bias (n = 11) and one had a high risk; however, only six reported effect sizes or power analyses. Multiple measures of neurocognitive outcomes were used (>50) and level of impairment criteria varied considerably. Memory impairments were frequently found and were also more likely to be impaired followed by executive function and processing speed. DISCUSSION This review highlights the heterogeneity of measures and approaches used to assess neurocognitive outcomes following OHCA as well as the need to improve risk of bias concerning generalizability. Improved understanding of the approaches used for assessment and the subsequent findings will facilitate a standardized evaluation of neurocognitive outcomes following OHCA.
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Affiliation(s)
- Nancy Zook
- Health and Applied Sciences, University of the West of England, Bristol, UK.
| | - Sarah Voss
- Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Erik Blennow Nordström
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden
| | - Stephen J Brett
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Pauline Shaw
- Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Paul White
- Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Jonathan Benger
- Health and Applied Sciences, University of the West of England, Bristol, UK
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7
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Mion M, Case R, Smith K, Lilja G, Blennow Nordström E, Swindell P, Nikolopoulou E, Davis J, Farrell K, Gudde E, Karamasis GV, Davies JR, Toff WD, Abella BS, Keeble TR. Follow-up care after out-of-hospital cardiac arrest: A pilot study of survivors and families' experiences and recommendations. Resusc Plus 2021; 7:100154. [PMID: 34386781 PMCID: PMC8342775 DOI: 10.1016/j.resplu.2021.100154] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 01/27/2023] Open
Abstract
Background and objectives Cognitive and physical difficulties are common in survivors of out-of-hospital cardiac arrest (OHCA); both survivors and close family members are also at risk of developing mood disorders. In the UK, dedicated follow-up pathways for OHCA survivors and their family are lacking. A cohort of survivors and family members were surveyed regarding their experience of post-discharge care and their recommended improvements. Method 123 OHCA survivors and 39 family members completed questionnaires during an educational event or later online. Questions addressed both the actual follow-up offered and the perceived requirements for optimal follow-up from the patient and family perspective, including consideration of timing, professionals involved, involvement of family members and areas they felt should be covered. Results Outpatient follow-up was commonly arranged after OHCA (77%). This was most often conducted by a cardiologist alone (80%) but survivors suggested that other professionals should also be involved (e.g. psychologist/counsellor, 64%). Topics recommended for consideration included cardiac arrest-related issues (heart disease; cause of arrest) mental fatigue/sleep disturbance, cognitive problems, emotional problems and daily activities. Most survivors advocated an early review (<1month; 61%). Most family members reported some psychological difficulties (95%); many of them (95%) advocated a dedicated follow-up appointment for family members of survivors. Conclusions The majority of OHCA survivors advocated an early follow-up following hospital discharge and a holistic, multidimensional assessment of arrest sequelae. These results suggest that current OHCA follow-up often fails to address patient-centred issues and to provide access to professionals deemed important by survivors and family members.
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Affiliation(s)
- Marco Mion
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK.,Anglia Ruskin University - Faculty of Health, Education, Medicine and Social Care, Chelmsford, UK
| | - Rosalind Case
- The Florey Institute of Neuroscience& Mental Health, Heidelberg, Victoria 3084, Australia
| | - Karen Smith
- Department of Epidemiology and Preventive Medicine, and Department of Community Emergency Health and Paramedic Practice, Monash University. University of Western Australia, Australia
| | - Gisela Lilja
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden
| | - Erik Blennow Nordström
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden
| | | | - Eleni Nikolopoulou
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK
| | - Jean Davis
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK
| | - Kelly Farrell
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK
| | - Ellie Gudde
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK
| | - Grigoris V Karamasis
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK.,Anglia Ruskin University - Faculty of Health, Education, Medicine and Social Care, Chelmsford, UK
| | - John R Davies
- Anglia Ruskin University - Faculty of Health, Education, Medicine and Social Care, Chelmsford, UK
| | - William D Toff
- Department of Cardiovascular Sciences, University of Leicester, and NIHR Leicester Cardiovascular Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Benjamin S Abella
- Center for Resuscitation Science, University of Pennsylvania, Philadelphia, USA
| | - Thomas R Keeble
- Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK.,Anglia Ruskin University - Faculty of Health, Education, Medicine and Social Care, Chelmsford, UK
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8
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Blennow Nordström E, Lilja G, Vestberg S, Ullén S, Friberg H, Nielsen N, Heimburg K, Evald L, Mion M, Segerström M, Grejs AM, Keeble T, Kirkegaard H, Ljung H, Rose S, Wise MP, Rylander C, Undén J, Cronberg T. Neuropsychological outcome after cardiac arrest: a prospective case control sub-study of the Targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest trial (TTM2). BMC Cardiovasc Disord 2020; 20:439. [PMID: 33028221 PMCID: PMC7542852 DOI: 10.1186/s12872-020-01721-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/30/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND This study is designed to provide detailed knowledge on cognitive impairment after out-of-hospital cardiac arrest (OHCA) and its relation to associated factors, and to validate the neurocognitive screening of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest trial (TTM2-trial), assessing effectiveness of targeted temperature management after OHCA. METHODS This longitudinal multi-center clinical study is a sub-study of the TTM2-trial, in which a comprehensive neuropsychological examination is performed in addition to the main TTM2-trial neurocognitive screening. Approximately 7 and 24 months after OHCA, survivors at selected study sites are invited to a standardized assessment, including performance-based tests of cognition and questionnaires of emotional problems, fatigue, executive function and insomnia. At 1:1 ratio, a matched control group from a cohort of acute myocardial infarction (MI) patients is recruited to perform the same assessment. We aim to include 100 patients per group. Potential differences between the OHCA patients and the MI controls at 7 and 24 months will be analyzed with a linear regression, using composite z-scores per cognitive domain (verbal, visual/constructive, working memory, episodic memory, processing speed, executive functions) as primary outcome measures. Results from OHCA survivors on the main TTM2-trial neurocognitive screening battery will be compared with neuropsychological test results at 7 months, using sensitivity and specificity analyses. DISCUSSION In this study we collect detailed information on cognitive impairment after OHCA and compare this to a control group of patients with acute MI. The validation of the TTM2 neurocognitive screening battery could justify its inclusion in routine follow-up. Our results may have a potential to impact on the design of future follow-up strategies and interventions after OHCA. TRIAL REGISTRATION ClinicalTrials.gov, NCT03543371 . Registered 1 June 2018.
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Affiliation(s)
- Erik Blennow Nordström
- Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Research Unit, Department of Clinical Sciences Lund, Neurology, Remissgatan 4, 221 85, Lund, Sweden.
| | - Gisela Lilja
- Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Research Unit, Department of Clinical Sciences Lund, Neurology, Remissgatan 4, 221 85, Lund, Sweden
| | | | - Susann Ullén
- Skane University Hospital, Clinical Studies Sweden - Forum South, Lund, Sweden
| | - Hans Friberg
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Intensive and Perioperative Care, Malmö, Sweden
| | - Niklas Nielsen
- Lund University, Helsingborg Hospital, Department of Clinical Sciences Lund, Anesthesiology and Intensive Care, Lund, Sweden
| | - Katarina Heimburg
- Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Research Unit, Department of Clinical Sciences Lund, Neurology, Remissgatan 4, 221 85, Lund, Sweden
| | - Lars Evald
- Hammel Neurorehabilitation and Research Centre, Hammel, Denmark
| | - Marco Mion
- Essex Cardiothoracic Centre, Basildon and Thurrock University Hospitals, Basildon, UK
| | - Magnus Segerström
- Sahlgrenska University Hospital, Department of Neurology and Department of Cardiology, Gothenburg, Sweden
| | - Anders M Grejs
- Aarhus University Hospital and Aarhus University, Research Centre for Emergency Medicine, Emergency Department and Department of Clinical Medicine, Aarhus, Denmark
| | - Thomas Keeble
- Essex Cardiothoracic Centre, Basildon and Thurrock University Hospitals, Basildon, UK
- Department of Allied Health and Medicine, Anglia Ruskin School of Medicine, Chelmsford, UK
| | - Hans Kirkegaard
- Aarhus University Hospital and Aarhus University, Research Centre for Emergency Medicine, Emergency Department and Department of Clinical Medicine, Aarhus, Denmark
| | - Hanna Ljung
- Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Research Unit, Department of Clinical Sciences Lund, Neurology, Remissgatan 4, 221 85, Lund, Sweden
| | - Sofia Rose
- Clinical Psychology, Cardiff and Vale University Health Board, NHS Wales, Cardiff, UK
| | | | - Christian Rylander
- Sahlgrenska Academy, University of Gothenburg, Institute of Clinical Sciences, Department of Anaesthesiology and Intensive Care Medicine, Gothenburg, Sweden
| | - Johan Undén
- Lund University, Skane University Hospital, Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine, Lund, Sweden
| | - Tobias Cronberg
- Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Research Unit, Department of Clinical Sciences Lund, Neurology, Remissgatan 4, 221 85, Lund, Sweden
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9
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Nordström EB, Lilja G, Vestberg S, Nielsen N, Cronberg T. Neuropsychological outcome after cardiac arrest: Rationale and description of a sub-study of The Target Temperature Management 2 Trial. Resuscitation 2018. [DOI: 10.1016/j.resuscitation.2018.07.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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10
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Lilja G, Blennow Nordström E. What you ask for is what you get: A practical approach for early cognitive screening and the potential for individualized support after cardiac arrest. Resuscitation 2017; 116:A5-A6. [PMID: 28501591 DOI: 10.1016/j.resuscitation.2017.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 05/03/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Gisela Lilja
- Lund University, Skane University Hospital, Department of Clinical Sciences, Neurology, Lund, Sweden.
| | - Erik Blennow Nordström
- Lund University, Skane University Hospital, Department of Clinical Sciences, Neurology, Lund, Sweden
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11
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Santillo AF, Lundblad K, Nilsson M, Landqvist Waldö M, van Westen D, Lätt J, Blennow Nordström E, Vestberg S, Lindberg O, Nilsson C. Grey and White Matter Clinico-Anatomical Correlates of Disinhibition in Neurodegenerative Disease. PLoS One 2016; 11:e0164122. [PMID: 27723823 PMCID: PMC5056728 DOI: 10.1371/journal.pone.0164122] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 09/20/2016] [Indexed: 11/30/2022] Open
Abstract
Disinhibition is an important symptom in neurodegenerative diseases. However, the clinico-anatomical underpinnings remain controversial. We explored the anatomical correlates of disinhibition in neurodegenerative disease using the perspective of grey and white matter imaging. Disinhibition was assessed with a neuropsychological test and a caregiver information-based clinical rating scale in 21 patients with prefrontal syndromes due to behavioural variant frontotemporal dementia (n = 12) or progressive supranuclear palsy (n = 9), and healthy controls (n = 25). Cortical thickness was assessed using the Freesurfer software on 3T MRI data. The integrity of selected white matter tracts was determined by the fractional anisotropy (FA) from Diffusion Tensor Imaging. Disinhibition correlated with the cortical thickness of the right parahippocampal gyrus, right orbitofrontal cortex and right insula and the FA of the right uncinate fasciculus and right anterior cingulum. Notably, no relationship was seen with the thickness of ventromedial prefrontal cortex. Our results support an associative model of inhibitory control, distributed in a medial temporal lobe-insular-orbitofrontal network, connected by the intercommunicating white matter tracts. This reconciles some of the divergences among previous studies, but also questions the current conceptualisation of the “prefrontal” syndrome and the central role attributed to the ventromedial prefrontal cortex in inhibitory control.
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Affiliation(s)
| | - Karl Lundblad
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Markus Nilsson
- Lund University Bioimaging Centre (LBIC), Lund University, Lund, Sweden
| | - Maria Landqvist Waldö
- Geriatric Psychiatry Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Danielle van Westen
- Center for Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Jimmy Lätt
- Center for Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Erik Blennow Nordström
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Susanna Vestberg
- Geriatric Psychiatry Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Psychology, Lund University, Lund, Sweden
| | - Olof Lindberg
- Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
| | - Christer Nilsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
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12
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Cardoso F, Costa A, Norton L, Senkus E, Aapro M, André F, Barrios CH, Bergh J, Biganzoli L, Blackwell KL, Cardoso MJ, Cufer T, El Saghir N, Fallowfield L, Fenech D, Francis P, Gelmon K, Giordano SH, Gligorov J, Goldhirsch A, Harbeck N, Houssami N, Hudis C, Kaufman B, Krop I, Kyriakides S, Lin UN, Mayer M, Merjaver SD, Nordström EB, Pagani O, Partridge A, Penault-Llorca F, Piccart MJ, Rugo H, Sledge G, Thomssen C, Van't Veer L, Vorobiof D, Vrieling C, West N, Xu B, Winer E. ESO-ESMO 2nd international consensus guidelines for advanced breast cancer (ABC2)†. Ann Oncol 2014; 25:1871-1888. [PMID: 25234545 PMCID: PMC4176456 DOI: 10.1093/annonc/mdu385] [Citation(s) in RCA: 284] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 08/11/2014] [Indexed: 12/23/2022] Open
Affiliation(s)
- F Cardoso
- European School of Oncology & Breast Unit, Champalimaud Cancer Center, Lisbon, Portugal.
| | - A Costa
- European School of Oncology, Milan, Italy; European School of Oncology, Bellinzona, Switzerland
| | - L Norton
- Breast Cancer Program, Memorial Sloan-Kettering Cancer Centre, New York, USA
| | - E Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - M Aapro
- Division of Oncology, Institut Multidisciplinaire d'Oncologie, Genolier, Switzerland
| | - F André
- Department of Medical Oncology, Gustave-Roussy Institute, Villejuif, France
| | - C H Barrios
- Department of Medicine, PUCRS School of Medicine, Porto Alegre, Brazil
| | - J Bergh
- Department of Oncology/Radiumhemmet, Karolinska Institutet & Cancer Center Karolinska and Karolinska University Hospital, Stockholm, Sweden
| | - L Biganzoli
- Department of Medical Oncology, Sandro Pitigliani Oncology Centre, Prato, Italy
| | - K L Blackwell
- Breast Cancer Clinical Program, Duke Cancer Institute, Durham, USA
| | - M J Cardoso
- Breast Unit, Champalimaud Cancer Center, Lisbon, Portugal
| | - T Cufer
- University Clinic Golnik, Medical Faculty Ljubljana, Ljubljana, Slovenia
| | - N El Saghir
- NK Basile Cancer Institute Breast Center of Excellence, American University of Beirut Medical Center, Beirut, Lebanon
| | - L Fallowfield
- Brighton & Sussex Medical School, University of Sussex, Falmer, UK
| | - D Fenech
- Breast Care Support Group, Europa Donna Malta, Mtarfa, Malta
| | - P Francis
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - K Gelmon
- BC Cancer Agency, Vancouver, Canada
| | - S H Giordano
- Departments of Health Services Research and Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, USA
| | - J Gligorov
- APHP Tenon, IUC-UPMC, Francilian Breast Intergroup, AROME, Paris, France
| | - A Goldhirsch
- Program of Breast Health, European Institute of Oncology, Milan, Italy
| | - N Harbeck
- Brustzentrum der Universität München, Munich, Denmark
| | - N Houssami
- Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - C Hudis
- Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - B Kaufman
- Sheba Medical Center, Tel Hashomer, Israel
| | - I Krop
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | | | - U N Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | | | - S D Merjaver
- University of Michigan Medical School and School of Public Health, Ann Arbor, USA
| | - E B Nordström
- Europa Donna Sweden & Bröstcancerföreningarnas Riksorganisation, BRO, Sundbyberg, Sweden
| | - O Pagani
- Oncology Institute of Southern Switzerland and Breast Unit of Southern Switzerland, Bellinzona, Switzerland
| | - A Partridge
- Department Medical Oncology, Division of Women's Cancers, Dana-Farber Cancer Institute, Boston, USA
| | - F Penault-Llorca
- Jean Perrin Centre, Comprehensive Cancer Centre, Clermont Ferrand, France
| | - M J Piccart
- Department of Medicine, Institut Jules Bordet, Brussels, Belgium
| | - H Rugo
- Department of Medicine, Breast Oncology Program, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco
| | - G Sledge
- Indiana University Medical CTR, Indianapolis, USA
| | - C Thomssen
- Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle an der Saale, Germany
| | - L Van't Veer
- Breast Oncology Program, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, USA
| | - D Vorobiof
- Sandton Oncology Centre, Johannesburg, South Africa
| | - C Vrieling
- Department of Radiotherapy, Clinique des Grangettes, Geneva, Switzerland
| | - N West
- Nursing Division, Health Board, Cardiff and Vale University, Cardiff, UK
| | - B Xu
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - E Winer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
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13
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Cardoso F, Costa A, Norton L, Senkus E, Aapro M, André F, Barrios CH, Bergh J, Biganzoli L, Blackwell KL, Cardoso MJ, Cufer T, El Saghir N, Fallowfield L, Fenech D, Francis P, Gelmon K, Giordano SH, Gligorov J, Goldhirsch A, Harbeck N, Houssami N, Hudis C, Kaufman B, Krop I, Kyriakides S, Lin UN, Mayer M, Merjaver SD, Nordström EB, Pagani O, Partridge A, Penault-Llorca F, Piccart MJ, Rugo H, Sledge G, Thomssen C, Van't Veer L, Vorobiof D, Vrieling C, West N, Xu B, Winer E. ESO-ESMO 2nd international consensus guidelines for advanced breast cancer (ABC2). Breast 2014; 23:489-502. [PMID: 25244983 DOI: 10.1016/j.breast.2014.08.009] [Citation(s) in RCA: 194] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 08/12/2014] [Indexed: 12/25/2022] Open
Affiliation(s)
- F Cardoso
- European School of Oncology & Breast Unit, Champalimaud Cancer Center, Lisbon, Portugal.
| | - A Costa
- European School of Oncology, Milan, Italy; European School of Oncology, Bellinzona, Switzerland
| | - L Norton
- Breast Cancer Program, Memorial Sloan-Kettering Cancer Centre, New York, USA
| | - E Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - M Aapro
- Division of Oncology, Institut Multidisciplinaire d'Oncologie, Genolier, Switzerland
| | - F André
- Department of Medical Oncology, Gustave-Roussy Institute, Villejuif, France
| | - C H Barrios
- Department of Medicine, PUCRS School of Medicine, Porto Alegre, Brazil
| | - J Bergh
- Department of Oncology/Radiumhemmet, Karolinska Institutet & Cancer Center Karolinska and Karolinska University Hospital, Stockholm, Sweden
| | - L Biganzoli
- Department of Medical Oncology, Sandro Pitigliani Oncology Centre, Prato, Italy
| | - K L Blackwell
- Breast Cancer Clinical Program, Duke Cancer Institute, Durham, USA
| | - M J Cardoso
- Breast Unit, Champalimaud Cancer Center, Lisbon, Portugal
| | - T Cufer
- University Clinic Golnik, Medical Faculty Ljubljana, Ljubljana, Slovenia
| | - N El Saghir
- NK Basile Cancer Institute Breast Center of Excellence, American University of Beirut Medical Center, Beirut, Lebanon
| | - L Fallowfield
- Brighton & Sussex Medical School, University of Sussex, Falmer, UK
| | - D Fenech
- Breast Care Support Group, Europa Donna Malta, Mtarfa, Malta
| | - P Francis
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - K Gelmon
- BC Cancer Agency, Vancouver, Canada
| | - S H Giordano
- Departments of Health Services Research and Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, USA
| | - J Gligorov
- APHP Tenon, IUC-UPMC, Francilian Breast Intergroup, Arome, Paris, France
| | - A Goldhirsch
- Program of Breast Health, European Institute of Oncology, Milan, Italy
| | - N Harbeck
- Brustzentrum der Universität München, Munich, DE, USA
| | - N Houssami
- Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - C Hudis
- Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - B Kaufman
- Sheba Medical Center, Tel Hashomer, Israel
| | - I Krop
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | | | - U N Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - M Mayer
- Advanced BC.org, New York, USA
| | - S D Merjaver
- University of Michigan Medical School and School of Public Health, Ann Arbor, USA
| | - E B Nordström
- Europa Donna Sweden & Bröstcancerföreningarnas Riksorganisation, BRO, Sundbyberg, Sweden
| | - O Pagani
- Oncology Institute of Southern Switzerland and Breast Unit of Southern Switzerland, Bellinzona, Switzerland
| | - A Partridge
- Department Medical Oncology, Division of Women's Cancers, Dana-Farber Cancer Institute, Boston, USA
| | - F Penault-Llorca
- Jean Perrin Centre, Comprehensive Cancer Centre, Clermont Ferrand, France
| | - M J Piccart
- Department of Medicine, Institut Jules Bordet, Brussels, Belgium
| | - H Rugo
- Department of Medicine, Breast Oncology Program, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, USA
| | - G Sledge
- Indiana University Medical CTR, Indianapolis, USA
| | - C Thomssen
- Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle an der Saale, DE, Germany
| | - L Van't Veer
- Breast Oncology Program, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, USA
| | - D Vorobiof
- Sandton Oncology Centre, Johannesburg, South Africa
| | - C Vrieling
- Department of Radiotherapy, Clinique des Grangettes, Geneva, Switzerland
| | - N West
- Nursing Division, Health Board, Cardiff and Vale University, Cardiff, UK
| | - B Xu
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - E Winer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
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