Abstract 137: The Impact of Psychological Distress on Six-Month Recovery Perceptions in Survivors of Cardiac Arrest

Abstract

Introduction: To determine the association of depressive and posttraumatic stress disorder symptoms with cardiac arrest (CA) survivors’ long-term recovery perceptions, after accounting for cognitive status, functional independence, and medical comorbidities. Hypothesis: We recently demonstrated that posttraumatic stress and depressive symptoms, not cognitive or functional impairment, were associated with cardiac arrest survivors’ negative recovery perceptions at hospital discharge. Current study aims to extend this work by examining the correlates of perceived recovery in these CA survivors at 6 months after their hospital discharge. Methods: Perceived recovery of 78 prospectively enrolled CA survivors at 6-months post-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 (PCL-S). Logistic regression was utilized to assess the association between depression and PTSD symptoms with positive and negative recovery perceptions, adjusting for demographics, cognitive impairment (Repeatable Battery for Assessment of Neuropsychological Status or Telephone Interview for Cognitive Status), functional dependence (Modified Lawton Instrumental Activities of Daily Living), and medical comorbidities (Charlson Comorbidity Index). Results: At 6 months, 53% of patients (n=41) had a negative recovery perception. 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 a negative recovery perception in both unadjusted (Odds Ratio (OR): 1.10, 95% Confidence Interval (CI) [1.4, 1.16], p<0.001) and adjusted analyses (OR: 1.10, 95% CI [1.03, 1.16], p<0.01). PCL-S scores were significantly associated with negative recovery perception in an unadjusted model (OR: 1.05, 95% CI [1.01, 1.10], p < 0.01), but not after adjustment of covariates. Conclusions: In contrast with cognitive and functional measures, psychological symptoms were strongly associated with cardiac arrest survivors’ negative recovery perceptions at 6-months post-discharge.