Department of Neurology, Columbia University Medical Center, New York, NY, United States.
Department of Surgery, Columbia University Medical Center, New York, NY, United States.
Gen Hosp Psychiatry. 2018 Jul-Aug;53:108-113. doi: 10.1016/j.genhosppsych.2018.02.006. Epub 2018 May 10.
To test the hypothesis that posttraumatic stress and depressive symptoms, not cognitive or functional impairment, are associated with cardiac arrest survivors' negative recovery perceptions at hospital discharge.
Prospective observational cohort of cardiac arrest patients admitted between 9/2015-5/2017. Survival to discharge with sufficient mental status to complete a psychosocial interview was the main inclusion criterion. Perceived recovery was assessed through the question, "Do you feel that you have made a complete recovery from your arrest?" The following measures were examined as potential correlates of perceived recovery: Repeatable Battery for Assessment of Neuropsychological Status, Modified Lawton Physical Self-Maintenance Scale, Barthel Index, Modified Rankin Scale, Cerebral Performance Category, Center for Epidemiological Studies-Depression (CES-D), and PTSD Checklist-Specific (PCL-S). Logistic regression evaluated associations between perceived recovery and potential correlates of recovery.
64/354 patients (58% men, 48% white, mean age 52 ± 17) were included. 67% (n = 43) had a negative recovery perception. There were no differences among patients' cognitive and functional domains. In individual models, patients with higher PCL-S and CES-D scores were more likely to have a negative recovery perception after adjusting for age and gender (OR: 1.2, 95% CI [1.1, 1.4], p = 0.003) and (OR: 1.1, 95% CI [1.0, 1.1], p = 0.05).
Within one month after a cardiac arrest event, survivors' negative recovery perceptions are associated with psychological distress.
验证假设，即创伤后应激和抑郁症状与心脏骤停幸存者出院时的负面恢复认知有关，而不是认知或功能障碍。
这是一项前瞻性观察性队列研究，纳入了 2015 年 9 月至 2017 年 5 月期间入院的心脏骤停患者。主要纳入标准为存活至出院且精神状态足以完成心理社会访谈。通过“您是否觉得您已经从心脏骤停中完全康复了？”这一问题来评估恢复感知。研究还考察了以下可能与感知恢复相关的措施：重复性成套神经心理状态评估量表、改良 Lawton 身体自理量表、巴氏指数、改良 Rankin 量表、脑功能分级、流行病学研究中心抑郁量表（CES-D）和创伤后应激障碍检查表特异性（PCL-S）。逻辑回归评估了感知恢复与恢复相关因素之间的关系。
共有 354 例患者中的 64 例（58%为男性，48%为白人，平均年龄 52±17 岁）纳入研究。67%（n=43）的患者存在负面恢复感知。患者的认知和功能领域无差异。在单因素模型中，在校正年龄和性别后，PCL-S 和 CES-D 评分较高的患者更有可能存在负面恢复感知（OR：1.2，95%CI [1.1，1.4]，p=0.003）和（OR：1.1，95%CI [1.0，1.1]，p=0.05）。
在心脏骤停事件发生后一个月内，幸存者的负面恢复感知与心理困扰有关。
