Surviving out-of-hospital cardiac arrest linked to greater anxiety, depression among women
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Key takeaways:
- Women had significantly greater medication use for anxiety/depression 5 years after out-of-hospital cardiac arrest.
- Changes in socioeconomic factors were not significantly different from the general population.
Anxiety and depression medication use rose significantly among women in the 5 years after out-of-hospital cardiac arrest, according to a real-world study published in Circulation: Cardiovascular Quality and Outcomes.
Researchers also identified declines in employment rates and household income among survivors of out-of-hospital cardiac arrest, but these declines did not significantly differ from those observed in the general population, results showed.
“It is crucial to identify changes in the lives of women and men who survived out-of-hospital cardiac arrest to be able to adopt a patient-oriented approach that goes beyond a focus on mere survival,” Robin L.A. Smits, MSc, a PhD candidate in the department of public and occupational health at Amsterdam University Medical Center, and colleagues wrote. “Gaining insights into long-term changes in both socioeconomic and mental health factors can assist caregivers, patients and their families in comprehending the lasting impact of out-of-hospital cardiac arrest on daily life.”
Researchers tracked the socioeconomic and mental health status of 1,255 people (259 women; median age, 63 years) from North Holland, the Netherlands, who experienced out-of-hospital cardiac arrest from 2009 to 2015 and survived for at least 30 days after the event. Specifically, researchers used sex-stratified generalized linear mixed models to identify how employment, income, primary earner status, and anxiety and depression medication use changed from 1 year before out-of-hospital cardiac arrest to 5 years after.
Additionally, the researchers compared each participant with two members of the general population.
To avoid retirement affecting the employment analysis, the researchers ran a separate analysis on those aged 60 years and younger at baseline, which included 111 women (median age, 51 years) and 398 men (median age, 53.5 years). Among this group, employment rates decreased from baseline to 5 years after out-of-hospital cardiac arrest among both women (72.8% to 53.4%) and men (80.9% to 63.7%; P < .001 for both). Median income also declined each year after out-of-hospital cardiac arrest for women (P = .002) and men (P < .001).
Researchers also observed a slight increase in the primary earner status among women (22.5% vs. 27.4%) but a decrease among men (77.8% vs. 76.7%)
Anxiety and depression medication use was significantly higher among all women participants, especially after 1 year (OR = 5.68; 95% CI, 2.05-15.74) and 5 years (OR = 5.73; 95% CI, 1.88-17.53), but no significant difference was seen in men at any time point. The researchers noted the higher use of anxiety and depression medication could be due in part to lower household income (change in beta estimate > 10%).
However, other than anxiety and depression medication use among women after out-of-hospital cardiac arrest, which appeared greater compared with the general population (P =.02), the trends related to income and socioeconomic status were similar to those observed in the general population.
“When compared with the general population, the observed decline in employment and income and a sex difference in trend in primary earner status did not seem drastic,” the researchers wrote. “However, future research should investigate the quality of the return to work and the causes underlying the decision not to return. Understanding whether employment or not returning to work is a personal choice or a consequence of an inability to work will guide health care professionals in providing appropriate support to these individuals.”
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Smits RLA, et al. Circ Cardiovasc Qual Outcomes. 2024;doi:10.1161/CIRCOUTCOMES.124.011072.
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