Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, USA.
Department of Clinical Epidemiology, Biostatistics and Bioinformatics Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Resuscitation. 2019 Mar;136:131-135. doi: 10.1016/j.resuscitation.2019.01.035. Epub 2019 Feb 5.
Sudden cardiac arrest (SCA) is a major public health challenge in the United States (US). At present, the existence of limited literature on psychological sequelae post-cardiac arrest is a challenge in providing optimal care to survivors.
The aim of this study is to determine the prevalence of various psychiatric comorbidities in survivors of SCA.
The National Inpatient Sample (NIS) dataset was queried to assess the prevalence of psychiatric disorders with gender-based differences and inpatient mortality among adult patients hospitalized with a previous history of SCA using ICD-9 CM codes from 2010 to 2014.
Mood disorder (16.4%) was the most prevalent psychiatric comorbidity (including depression; 12.6%) followed by anxiety (10%). Cardiac arrest survivors with psychiatric disorder (CAPD) were often younger (mean 60 ± 16 vs. 64 ± 16 years; p < 0.001), female (53.7% vs. 38.0%; p < 0.001), white patients (75.9% vs. 68.7%; p < 0.001) and the majority were admitted non-electively (85.1% vs. 82.8%, p < 0.001) as compared to cardiac arrest survivors without psychiatric disorder (CANPD). Among the CAPD group, females had a significantly higher frequency of mood disorders (21.8% vs. 12.6%), depression (16.8% vs. 9.5%) and anxiety (14.2% vs. 8.0%) compared to males. The CAPD cohort had a lower all-cause in-hospital mortality (5.7% vs. 9.8%; p < 0.001) as compared to the CANPD group.
Comorbid psychiatric disorders are prevalent in SCA survivors, especially younger, white, female patients. However, CAPD did not have higher all-cause mortality as compared to CANPD. It is imperative to identify, assess, treat, and monitor high-risk SCA patients for associated psychiatric comorbidities.
在美国，心搏骤停（SCA）是一项重大的公共卫生挑战。目前，关于心搏骤停后心理后遗症的文献有限，这给幸存者提供最佳护理带来了挑战。
本研究旨在确定 SCA 幸存者中各种精神共病的患病率。
使用国际疾病分类第 9 版临床修正（ICD-9-CM）代码，从 2010 年至 2014 年，从国家住院患者样本（NIS）数据库中查询评估过去有 SCA 病史的成年患者中，精神障碍的患病率及基于性别差异的住院死亡率。
心境障碍（16.4%）是最常见的精神共病（包括抑郁；12.6%），其次是焦虑（10%）。患有精神障碍的心搏骤停幸存者（CAPD）通常更年轻（平均 60±16 岁 vs. 64±16 岁；p<0.001），女性（53.7% vs. 38.0%；p<0.001），白人患者（75.9% vs. 68.7%；p<0.001），大多数为非择期入院（85.1% vs. 82.8%，p<0.001），而无精神障碍的心搏骤停幸存者（CANPD）则不然。在 CAPD 组中，女性心境障碍（21.8% vs. 12.6%）、抑郁（16.8% vs. 9.5%）和焦虑（14.2% vs. 8.0%）的频率明显高于男性。与 CANPD 组相比，CAPD 组的全因住院死亡率较低（5.7% vs. 9.8%；p<0.001）。
SCA 幸存者中常见合并精神障碍，尤其是年轻、白人、女性患者。然而，与 CANPD 相比，CAPD 的全因死亡率并没有更高。识别、评估、治疗和监测高危 SCA 患者的相关精神共病至关重要。
