To explore factors associated with health status and psychological distress among cardiac arrest (CA) survivors treated with an implantable cardioverter-defibrillator (ICD), and to compare their health status with a general Swedish population.
Materials and methods
This cross-sectional study included 990 adults treated with an ICD after suffering from CA due to ventricular fibrillation. All participants received a questionnaire including self-reported data on demographics and comorbidities, and instruments to measure health status (EQ-5D-3L), psychological distress (HADS), ICD-related concerns (ICDC), perceived control (CAS) and type D personality (DS-14). Health status (EQ index) was compared to a general Swedish population, matched for age and gender. Linear regression analyses were used to explore factors associated with four outcome variables; EQ index, EQ VAS (health status), HADS anxiety and HADS depression (psychological distress).
The participants reported better health status in EQ index (m=0.84 vs. 0.79, p<0.001) and less pain/discomfort (m=1.40 vs. m=1.70, p<0.001) compared to the general population. In contrast, they reported more problems in mobility (m=1.27 vs. m=1.21, p=0.002) and usual activities (m=1.20 vs. m=1.12, p<0.001). The following factors were independently associated with worse outcome in all four final regression models; 1) being unemployed, 2) suffering more comorbidity, 3) perceiving less control and 4) having a type D personality. Further, being a woman and suffering ICD-related concerns were independently associated with worse outcome in three of the models.
This extensive population-based study showed that health status among most ICD treated CA survivors is good, even when compared to a general population. Several factors predicting worse health status and more psychological distress were identified. These results might be used when screening patients for health problems during post CA follow-up and when developing health promoting interventions.