The impact of psychological distress on long-term recovery perceptions in survivors of cardiac arrest

J Crit Care. 2019 Apr:50:227-233. doi: 10.1016/j.jcrc.2018.12.011. Epub 2018 Dec 18.

Abstract

Purpose: To determine the association of depressive and PTSD symptoms with cardiac arrest survivors' long-term recovery perceptions, after accounting for cognitive status, functional independence, and medical comorbidities.

Methods: Perceived recovery of 78 cardiac arrest survivors at 6-months post-hospital discharge was assessed through the question, "Do you feel that you have made a complete recovery from your arrest?" Psychological symptoms were measured using the Center for Epidemiological Studies-Depression scale (CES-D) and the PTSD Checklist-Specific (PCLS). Logistic regression was utilized to assess the association between psychological symptoms with positive and negative recovery perceptions, adjusting for demographics, cognitive impairment, functional dependence, and medical comorbidities.

Results: At 6 months, 53% of patients (n = 41) had negative recovery perceptions. 32.1% (n = 25) of patients screened for depression and 28.2% (n = 22) for PTSD. Patients with higher CES-D scores were significantly more likely to have negative recovery perceptions in both unadjusted and adjusted analyses (OR: 1.10, 95% CI [1.03, 1.16], p < .01). PCL-S scores were significantly associated with negative recovery perceptions in an unadjusted model (OR: 1.05, 95% CI [1.01, 1.10], p < .01), but not after adjustment of covariates.

Conclusions: In contrast with cognitive and functional measures, depressive symptoms were strongly associated with cardiac arrest survivors' negative recovery perceptions at 6-months post-discharge.

Keywords: Cardiac arrest; Cognitive dysfunction; Depression; Neuropsychological tests; Patient report outcome measures; Perception; Posttraumatic stress disorder; Value based health care.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Heart Arrest / complications
  • Heart Arrest / psychology*
  • Heart Arrest / rehabilitation
  • Humans
  • Male
  • Middle Aged
  • Patient Discharge
  • Stress Disorders, Post-Traumatic / physiopathology
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress Disorders, Post-Traumatic / rehabilitation
  • Survivors / psychology*