The psychosocial outcomes of anoxic brain injury following cardiac arrest

Abstract

Aim of the study: This exploratory study aimed to investigate the psychosocial outcomes for cardiac arrest survivors and explore if there is a greater impact on psychosocial outcome for individuals experiencing anoxic brain injury as a result of the cardiac arrest. Methods: Self-report measures were used to compare the quality of life, social functioning and symptoms of anxiety, depression and post-traumatic stress of individuals with and without anoxic brain injury. Secondary measures of subjective memory and executive difficulties were also used. Fifty-six participants (27 with anoxia, 29 without anoxia) took part in the study between six months and four years after experiencing cardiac arrest. Results: A MANOVA identified a significant difference between the two groups, with the anoxia group reporting more psychosocial difficulties. They reported more social functioning difficulties and more anxiety, depression and post-traumatic stress symptoms. There was, however, no significant difference in self-reported quality of life between the two groups. Conclusion: As the first known study to compare psychosocial outcomes for cardiac arrest survivors experiencing anoxic brain injury with those without anoxia, the current results suggest that cardiac arrest survivors with subsequent acquired brain injury experience more psychosocial difficulties. This could be due to a combination of neuropsychological, social and psychological factors. © 2014 Elsevier Ireland Ltd

Survivors' quality of life after cardiopulmonary resuscitation: an integrative review of the literature

“…However, one paper reported high levels of anxiety after 3 years of the event . The paper reporting on the influence of anoxic brain injury caused by CA identified increased levels of both anxiety and depression, compared to survivors without anoxia. Two papers reported that the majority of survivors of CPR did not differ in anxiety and depression from the normal population and a further study claimed that most participants have no cognitive impairment, no depression or severe impairment in health.…”

“…Two papers reported that the majority of survivors of CPR did not differ in anxiety and depression from the normal population and a further study claimed that most participants have no cognitive impairment, no depression or severe impairment in health. Sourced papers most commonly included neurologically intact survivors, with only three papers indicating the inclusion of the whole spectrum of CPC categories from 1 to 4 .…”

“…The variation in time point from 1 month (14,) to 5 years between CPR and survey in the papers can also influence the results as some survivors could have sought treatment for their anxiety and depression. However, all papers highlight the commonality of both anxiety and depression and the influence it has on QOL . Similar to studies that measured levels of cognitive dysfunction, there was a marked variety of study methods and methodologies.…”

“…While the goal of CPR is to return the patient to a good functional level of life, data suggest that the evaluation of consequences after CA focuses mostly on survival with less emphasis given to other outcome measures. Elements of a person's QOL should be a main outcome measure in assessing the success of CPR , as cognitive impairment, predominantly memory dysfunction, plus fatigue, anxiety, depression and post‐traumatic stress disorder have been reported as common complaints after surviving CPR . It is pertinent to note that the World Health Organization defines QOL as ‘an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.…”

Cognitive and Functional Consequence of Cardiac Arrest

“…A recent study of 278 OHCA survivors reported prevalence of anxiety and depression at 24 and 13 %, respectively, which was higher but not significantly different to that of a control group of patients with myocardial infarction, and that anxiety and depression correlated to health-related quality of life and self-reported cognitive dysfunction [55]. Wilson et al found that patients who had experienced anoxic brain injury after cardiac arrest did worse psychosocially compared to cardiac arrest survivors without brain injury, including greater degrees of depression, anxiety, and PTSD, and that these difficulties correlated with self-reported cognitive problems [69]. Psychological concerns, especially anxiety spectrum disorders, are common in OHCA survivors and should be the focus of intervention.…”