Impact of Preexisting Depression and Anxiety on Hospital Readmission and Long-Term Survival After Cardiac Arrest.
| Autor: | Coppler PJ; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA., Brown M; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA., Moschenross DM; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA., Gopalan PR; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.; Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA., Presciutti AM; Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.; Department of Psychiatry, Harvard Medical School, Boston, MA, USA., Doshi AA; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA., Sawyer KN; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA., Frisch A; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA., Callaway CW; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA., Elmer J; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.; Department of Neurology Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of intensive care medicine [J Intensive Care Med] 2024 Jun; Vol. 39 (6), pp. 542-549. Date of Electronic Publication: 2023 Dec 10. |
| DOI: | 10.1177/08850666231218963 |
| Abstrakt: | Background: While sudden cardiac arrest (CA) survivors are at risk for developing psychiatric disorders, little is known about the impact of preexisting mental health conditions on long-term survival or postacute healthcare utilization. We examined the prevalence of preexisting psychiatric conditions in CA patients who survived hospital discharge, characterized incidence and reason for inpatient psychiatry consultation during these patients' acute hospitalizations, and determined the association of pre-CA depression and anxiety with hospital readmission rates and long-term survival. We hypothesized that prior depression or anxiety would be associated with higher hospital readmission rates and lower long-term survival. Methods: We conducted a retrospective cohort study including patients resuscitated from in- and out-of-hospital CA who survived both admission and discharge from a single hospital between January 1, 2010, and December 31, 2017. We identified patients from our prospective registry, then performed a structured chart review to abstract past psychiatric history, prescription medications for psychiatric conditions, and identify inpatient psychiatric consultations. We used administrative data to identify readmissions within 1 year and vital status through December 31, 2020. We used multivariable Cox regressions controlling for patient demographics, medical comorbidities, discharge Cerebral Performance Category and disposition, depression, and anxiety history to predict long-term survival and hospital readmission. Results: We included 684 subjects. Past depression or anxiety was noted in 24% ( n = 162) and 19% ( n = 129) of subjects. A minority of subjects ( n = 139, 20%) received a psychiatry consultation during the index hospitalization. Overall, 262 (39%) subjects had at least 1 readmission within 1 year. Past depression was associated with an increased hazard of hospital readmission (hazard ratio 1.50, 95% CI 1.11-2.04), while past anxiety was not associated with readmission. Neither depression nor anxiety were independently associated with long-term survival. Conclusions: Depression is an independent risk factor for hospital readmission in CA survivors. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Databáze: | MEDLINE |
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