Cor Vasa 2017, 59(3):e222-e228 | DOI: 10.1016/j.crvasa.2016.11.012

Psychosocial sequelae following cardiac arrest

Veronika Dostálová^a,b, Kamil Sedláček^c, Jan Bělohlávek^d, Radovan Turek^e, Martin Pretl^f, Ondřej Bezdíček^b,g,*

^a Psychiatrická klinika, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice v Praze, Praha, Česká republika

^b Pražská vysoká škola psychosociálních studií, s. r. o., Praha, Česká republika

^c Klinika kardiologie, Institut klinické a experimentální medicíny, Praha, Česká republika

^d II. interní klinika kardiologie a angiologie, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice v Praze, Praha, Česká republika

^e Anesteziologicko-resuscitační oddělení, Krajská nemocnice T. Bati, a. s., Zlín, Česká republika

^f Neurologická ambulance a Spánková poradna INSPAMED, s. r. o., Praha, Česká republika

^g Neurologická klinika a Centrum klinických neurověd, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice v Praze, Praha, Česká republika

Background: Cardiac arrest (CA) leads to cerebral hypoxia resulting in multifactorial brain injury. Cognitive impairment and a higher degree of depressive symptoms are the most frequently described mental health problems after CA. The aim of the present study is to characterize psychosocial sequelae of CA.

Methods: The study population included 113 subjects. 62 patients after CA were matched to 51 healthy controls according to demographic characteristics and premorbid intelligence level. Cognitive test (MoCA), inventories of depressive (BDI-II) and anxiety symptoms (STAI) and midlife crisis scale (MCS) were administrated to study participants.

Results: The analysis showed that CA patients have a decreased level of cognitive performance (p = 0.016) and a higher degree of state anxiety symptoms (p = 0.023). There was no significant difference between CA patients and control subjects in the degree of depressive (p = 0.435) and trait anxiety symptoms (p = 0.542). Ex-post facto analysis based on logistic regression indicated that the strongest predictors of being classified as having had a cardiac arrest was male gender and state anxiety (OR = 4.45 and 0.50). Discriminant function analysis showed that group prediction was sensitive to age, cognitive performance, and state anxiety (λ = 0.81, p = 0.028).

Conclusions: Our results show that CA has significant cognitive and neuropsychiatric sequelae. The integration of psychosocial care and neuropsychiatric treatment into the complex medical care of CA patients seems to be justified.

Keywords: Anxiety; Cardiac arrest; Cerebral hypoxic injury; Cognitive impairment; Depression; Midlife crisis

Received: May 4, 2016; Revised: November 18, 2016; Accepted: November 27, 2016; Published: June 1, 2017  Show citation