Survival odds lessened for individuals who develop PTSD after a major cardiac event
Survival odds are lessened for individuals who develop PTSD after a major cardiac event. According to researchers at the Technical University of Munich, individuals who received a cardioverter-defibrillator implant after cardiac arrest possessed a mortality rate 3.45 times higher if they developed strong PTSD symptoms. “Symptoms of PTSD, particularly intrusive recollections of adverse aspects of the disease course, have a substantial effect on survival in patients with implantable cardioverter-defibrillators,” the researchers wrote. The findings, which were published in the Archives of General Psychiatry, indicate the need for “… routinely applied comprehensive and interdisciplinary psychosocial aftercare” among patients in this population. The following is an excerpt of an article from Medpage Today that reviews the study:
The study involved 147 patients who were followed for a mean of 5.1 years (SD 2.2) after receiving the devices. Thirty-eight of these patients scored in the top quartile on a standard PTSD symptom scale.
Dr. Ladwig and colleagues calculated an event rate of 55 deaths per 1,000 person-years among those with low to moderate PTSD scores, compared with 80 deaths per 1,000 person-years among those with high PTSD scores.
The findings reflect adjustments for age, sex, diabetes status, scores on depression and anxiety scales, and several measures of cardiovascular disease severity.
The researchers said that, according to previous studies, some 27% to 38% of patients surviving an out-of-hospital cardiac arrest develop PTSD. The rate of PTSD following heart attacks appears somewhat lower, but may still top 30%.
Because many patients receiving cardioverter-defibrillators are survivors of such events, they are likely at risk for PTSD, the researchers said.
“Treatment with [the device] may act as a constant reminder of the underlying disease condition,” they noted.
All the patients in their sample had survived some type of life-threatening, sudden-onset cardiac condition. That met one of the main criteria for PTSD, but only the 38 scoring in the highest quartile on the revised Impact of Event Scale were categorized as PTSD index cases.