Anxiety and depression among out-of-hospital cardiac arrest survivors

作者：Lilja G^*; Nilsson G; Nielsen N; Friberg H; Hassager C; Koopmans M; Kuiper M; Martini A; Mellinghoff J; Pelosi P; Wanscher M; Wise M P; Ostman I; Cronberg T

来源：Resuscitation, 2015, 97: 68-75.

DOI：10.1016/j.resuscitation.2015.09.389

• Out-of-hospital cardiac arrest
• Resuscitation
• Anxiety
• Depression
• Patient outcome assessment
• Target temperature management

Aim: Survivors of out-of-hospital cardiac arrest (OHCA) may experience psychological distress but the actual prevalence is unknown. The aim of this study was to investigate anxiety and depression within a large cohort of OHCA-survivors.
Methods: OHCA-survivors randomized to targeted temperature of 33 degrees C or 36 degrees C within the Target Temperature Management trial (TTM-trial) attended a follow-up after 6 months that included the questionnaire Hospital Anxiety and Depression Scale (HADS). A control group with ST-elevation myocardial infarction (STEMI) completed the same follow-up. Correlations to variables assumed to be associated with anxiety and depression in OHCA-survivors were tested.
Results: At follow-up 278 OHCA-survivors and 119 STEMI-controls completed the HADS where 24% of OHCA-survivors (28% in 33 degrees C group/22% in 36 degrees C group, p = 0.83) and 19% of the STEMI-controls reported symptoms of anxiety (OR 1.32; 95% CI (0.78-2.25), p = 0.30). Depressive symptoms were reported by 13% of OHCA-survivors (equal in both intervention groups, p = 0.96) and 8% of STEMI-controls (OR 1.76; 95% CI (0.82-3.79), p = 0.15). Anxiety and depression among OHCA-survivors correlated to Health-Related Quality-of-Life, and subjectively reported cognitive deterioration by patient or observer. In addition, depression was associated with a poor neurological outcome.
Conclusion: One fourth of OHCA-survivors reported symptoms of anxiety and/or depression at 6 months which was similar to STEMI-controls and previous normative data. Subjective cognitive problems were associated with an increased risk for psychological distress. Since psychological distress affects long-term prognosis of cardiac patients in general it should be addressed during follow-up of survivors with OHCA due to a cardiac cause.

• 出版日期2015-12