Long-term physical functioning and psychosocial adjustment in survivors of sudden cardiac death.

OBJECTIVE

To identify and describe a range of functional health outcomes in a sample of sudden cardiac death survivors.

DESIGN

Cross-sectional survey.

SETTING

Northern California tertiary medical center.

SUBJECTS

Sixty-one sudden cardiac death survivors at least 6 months but not more than 4 years after cardiac arrest. Subjects were excluded if they had uncontrolled congestive heart failure, unstable angina, other debilitating cardiac or concomitant illness, or evident cognitive deficits.

METHODS

Chart reviews, patient interviews, and a standardized questionnaire.

RESULTS

Survivors reported significantly poorer physical functioning than normal subjects (p < 0.001), although none were limited in self-care. Mental Health Index Scores and subscale scores for psychologic well-being were within established norms. However, mean scores for the psychologic distress subscale were elevated (p < 0.001). Initial work return was 72%. Of the 37 (61%) survivors who were sexually active before their arrests, 78% resumed coitus. Twenty-five survivors reported mild to moderately severe impairments in memory or other cognitive skills. Poor physical functioning was associated with illness severity, change in work status, and increased anxiety. Psychologic distress was associated with change in work status and poor physical functioning, but not illness severity.

CONCLUSIONS

Despite significant decreases in physical functioning and reports of mild to moderately severe cognitive impairments, only a minority of sudden cardiac death survivors are severely psychologically distressed. Illness severity is a strong predictor of physical functioning, but its contribution to psychologic distress is indirect, acting largely through the aegis of poor physical functioning and loss of prearrest work status.