Maayke Hunfeld

215 Neuropsychological outcome longer-term impact and development of these cognitive vulnerabilities throughout their academic career and participation in daily life are still unclear. From follow-up studies in other children with vulnerable brains (e.g. with acquired brain injury after trauma or brain tumor treatment) we know that these children may grow into deficit over time (32-35) . Strengths and limitations Strength of our study is our representative study-population. Characteristics such as age, OHCA cause and distribution of sex are comparable with previous research (2, 6) . Furthermore, our cohort was homogeneous including solely OHCA survivors with a normal functioning pre-arrest with on-site visits at our outpatient clinic at standardised moments, including repeated neuropsychological testing up to 24 months after the OHCA event. Besides general intelligence scores, other more complex neuropsychological domains were assessed using validated, age-appropriate tests. As to limitations, the relatively high percentage of good PCPC scores may reflect a selection bias due to the high amount of withdrawal of intensive care treatment of children with an expected poor neurological outcome (7) . Our cohort was small (n=49) with a wide age-range. Due to age limitations, most neuropsychological domains were only tested in older children. When children were tested repeatedly, test batteries were not always the same. In our patients SES was significantly lower than the general Dutch population, which might have influenced the neurocognitive outcome. When we started the follow-up program, initially the loss to follow-up was high. This improved over time due to a more structured program. Due to these limitations, we were not able to find predictors for neurocognitive outcomes. We also did not include brain imaging as part of our standardised follow-up. Finally, in general OHCA children are offered structured rehabilitation or paramedical programs after discharge. When we started our follow-up program we initially didn’t inquire about this routinely. This resulted in many missing data, therefore we did not include this aspect in our description of the study population. Future directions Our findings underline the need for a standardised follow-up program (internationally) into adulthood as standard of care in OHCA survivors. In our opinion, this follow- up should include neurological and neuropsychological assessments; it should 7