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Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest

IMPORTANCE: The recent American Heart Association guidelines added a sixth link in the chain of survival highlighting recovery and emphasized the importance of psychiatric outcome and recovery for survivors of out-of-hospital cardiac arrest (OHCA). The prevalence of psychiatric disorders among this...

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Autores principales: Lee, Juncheol, Cho, Yongil, Oh, Jaehoon, Kang, Hyunggoo, Lim, Tae Ho, Ko, Byuk Sung, Yoo, Kyung Hun, Lee, Sang Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10098954/
https://www.ncbi.nlm.nih.gov/pubmed/37043200
http://dx.doi.org/10.1001/jamanetworkopen.2023.7809
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author Lee, Juncheol
Cho, Yongil
Oh, Jaehoon
Kang, Hyunggoo
Lim, Tae Ho
Ko, Byuk Sung
Yoo, Kyung Hun
Lee, Sang Hwan
author_facet Lee, Juncheol
Cho, Yongil
Oh, Jaehoon
Kang, Hyunggoo
Lim, Tae Ho
Ko, Byuk Sung
Yoo, Kyung Hun
Lee, Sang Hwan
author_sort Lee, Juncheol
collection PubMed
description IMPORTANCE: The recent American Heart Association guidelines added a sixth link in the chain of survival highlighting recovery and emphasized the importance of psychiatric outcome and recovery for survivors of out-of-hospital cardiac arrest (OHCA). The prevalence of psychiatric disorders among this population was higher than that in the general population. OBJECTIVE: To examine the prevalence of depression or anxiety and the association of these conditions with long-term mortality among individuals who survive OHCA. DESIGN, SETTING, AND PARTICIPANTS: A longitudinal population-based cohort study was conducted to analyze long-term prognosis in patients hospitalized for OHCA between January 1, 2005, and December 31, 2015, who survived for 1 year or longer. Patients with cardiac arrest due to traumatic or nonmedical causes, such as injuries, poisoning, asphyxiation, burns, or anaphylaxis, were excluded. Data were extracted on depression or anxiety diagnoses in this population within 1 year from the database of the Korean National Health Insurance Service and analyzed April 7, 2022, and reanalyzed January 19 to 20, 2023. MAIN OUTCOMES AND MEASURES: Follow-up data were obtained for up to 14 years, and the primary outcome was long-term cumulative mortality. Long-term mortality among patients with and without a diagnosis of depression or anxiety were evaluated. RESULTS: The analysis included 2373 patients; 1860 (78.4%) were male, and the median age was 53.0 (IQR, 44.0-62.0) years . A total of 397 (16.7%) patients were diagnosed with depression or anxiety, 251 (10.6%) were diagnosed with depression, and 227 (9.6%) were diagnosed with anxiety. The incidence of long-term mortality was significantly higher in the group diagnosed with depression or anxiety than in the group without depression or anxiety (141 of 397 [35.5%] vs 534 of 1976 [27.0%]; P = .001). With multivariate Cox proportional hazards regression analysis, the adjusted hazard ratio of long-term mortality for total patients with depression or anxiety was 1.41 (95% CI, 1.17-1.70); depression, 1.44 (95% CI, 1.16-1.79); and anxiety, 1.20 (95% CI, 0.94-1.53). CONCLUSIONS AND RELEVANCE: In this study, among the patients who experienced OHCA, those diagnosed with depression or anxiety had higher long-term mortality rates than those without depression or anxiety. These findings suggest that psychological and neurologic rehabilitation intervention for survivors of OHCA may be needed to improve long-term survival.
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spelling pubmed-100989542023-04-14 Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest Lee, Juncheol Cho, Yongil Oh, Jaehoon Kang, Hyunggoo Lim, Tae Ho Ko, Byuk Sung Yoo, Kyung Hun Lee, Sang Hwan JAMA Netw Open Original Investigation IMPORTANCE: The recent American Heart Association guidelines added a sixth link in the chain of survival highlighting recovery and emphasized the importance of psychiatric outcome and recovery for survivors of out-of-hospital cardiac arrest (OHCA). The prevalence of psychiatric disorders among this population was higher than that in the general population. OBJECTIVE: To examine the prevalence of depression or anxiety and the association of these conditions with long-term mortality among individuals who survive OHCA. DESIGN, SETTING, AND PARTICIPANTS: A longitudinal population-based cohort study was conducted to analyze long-term prognosis in patients hospitalized for OHCA between January 1, 2005, and December 31, 2015, who survived for 1 year or longer. Patients with cardiac arrest due to traumatic or nonmedical causes, such as injuries, poisoning, asphyxiation, burns, or anaphylaxis, were excluded. Data were extracted on depression or anxiety diagnoses in this population within 1 year from the database of the Korean National Health Insurance Service and analyzed April 7, 2022, and reanalyzed January 19 to 20, 2023. MAIN OUTCOMES AND MEASURES: Follow-up data were obtained for up to 14 years, and the primary outcome was long-term cumulative mortality. Long-term mortality among patients with and without a diagnosis of depression or anxiety were evaluated. RESULTS: The analysis included 2373 patients; 1860 (78.4%) were male, and the median age was 53.0 (IQR, 44.0-62.0) years . A total of 397 (16.7%) patients were diagnosed with depression or anxiety, 251 (10.6%) were diagnosed with depression, and 227 (9.6%) were diagnosed with anxiety. The incidence of long-term mortality was significantly higher in the group diagnosed with depression or anxiety than in the group without depression or anxiety (141 of 397 [35.5%] vs 534 of 1976 [27.0%]; P = .001). With multivariate Cox proportional hazards regression analysis, the adjusted hazard ratio of long-term mortality for total patients with depression or anxiety was 1.41 (95% CI, 1.17-1.70); depression, 1.44 (95% CI, 1.16-1.79); and anxiety, 1.20 (95% CI, 0.94-1.53). CONCLUSIONS AND RELEVANCE: In this study, among the patients who experienced OHCA, those diagnosed with depression or anxiety had higher long-term mortality rates than those without depression or anxiety. These findings suggest that psychological and neurologic rehabilitation intervention for survivors of OHCA may be needed to improve long-term survival. American Medical Association 2023-04-12 /pmc/articles/PMC10098954/ /pubmed/37043200 http://dx.doi.org/10.1001/jamanetworkopen.2023.7809 Text en Copyright 2023 Lee J et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Lee, Juncheol
Cho, Yongil
Oh, Jaehoon
Kang, Hyunggoo
Lim, Tae Ho
Ko, Byuk Sung
Yoo, Kyung Hun
Lee, Sang Hwan
Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest
title Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest
title_full Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest
title_fullStr Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest
title_full_unstemmed Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest
title_short Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest
title_sort analysis of anxiety or depression and long-term mortality among survivors of out-of-hospital cardiac arrest
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10098954/
https://www.ncbi.nlm.nih.gov/pubmed/37043200
http://dx.doi.org/10.1001/jamanetworkopen.2023.7809
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