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Intensive Care Medicine

02-05-2024 | Cardiogenic Shock | Original

Mental health sequelae in survivors of cardiogenic shock complicating myocardial infarction. A population-based cohort study

Authors: Shannon M. Fernando, Danial Qureshi, Robert Talarico, Simone N. Vigod, Daniel I. McIsaac, Lee H. Sterling, Sean van Diepen, Susanna Price, Pietro Di Santo, Kwadwo Kyeremanteng, Eddy Fan, Dale M. Needham, Daniel Brodie, Oscar Joseph Bienvenu, Alain Combes, Arthur S. Slutsky, Damon C. Scales, Margaret S. Herridge, Holger Thiele, Benjamin Hibbert, Peter Tanuseputro, Rebecca Mathew

Published in: Intensive Care Medicine

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Abstract

Purpose

Cardiogenic shock secondary to acute myocardial infarction (AMI-CS) is associated with substantial short- and long-term morbidity and mortality. However, there are limited data on mental health sequelae that survivors experience following discharge.

Methods

We conducted a retrospective, population-based cohort study in Ontario, Canada of critically ill adult (≥ 18 years) survivors of AMI-CS, admitted to hospital between April 1, 2009 and March 31, 2019. We compared these patients to AMI survivors without shock. We captured outcome data using linked health administrative databases. The primary outcome was a new mental health diagnosis (a composite of mood, anxiety, or related disorders; schizophrenia/psychotic disorders; and other mental health disorders) following hospital discharge. We secondarily evaluated incidence of deliberate self-harm and death by suicide. We compared patients using overlap propensity score-weighted, cause-specific proportional hazard models.

Results

We included 7812 consecutive survivors of AMI-CS, from 135 centers. Mean age was 68.4 (standard deviation (SD) 12.2) years, and 70.3% were male. Median follow-up time was 767 days (interquartile range (IQR) 225–1682). Incidence of new mental health diagnosis among AMI-CS survivors was 109.6 per 1,000 person-years (95% confidence interval (CI) 105.4–113.9), compared with 103.8 per 1000 person-years (95% CI 102.5–105.2) among AMI survivors without shock. After propensity score adjustment, there was no difference in the risk of new mental health diagnoses following discharge [hazard ratio (HR) 0.99 (95% CI 0.94–1.03)]. Factors associated with new mental health diagnoses following AMI-CS included female sex, pre-existing mental health diagnoses, and discharge to a long-term hospital or rehabilitation institute.

Conclusion

Survivors of AMI-CS experience substantial mental health morbidity following discharge. Risk of new mental health diagnoses was comparable between survivors of AMI with and without shock. Future research on interventions to mitigate psychiatric sequelae after AMI-CS is warranted.
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Metadata
Title
Mental health sequelae in survivors of cardiogenic shock complicating myocardial infarction. A population-based cohort study
Authors
Shannon M. Fernando
Danial Qureshi
Robert Talarico
Simone N. Vigod
Daniel I. McIsaac
Lee H. Sterling
Sean van Diepen
Susanna Price
Pietro Di Santo
Kwadwo Kyeremanteng
Eddy Fan
Dale M. Needham
Daniel Brodie
Oscar Joseph Bienvenu
Alain Combes
Arthur S. Slutsky
Damon C. Scales
Margaret S. Herridge
Holger Thiele
Benjamin Hibbert
Peter Tanuseputro
Rebecca Mathew
Publication date
02-05-2024
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-024-07399-3