Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest

Lee, J; Cho, Y; Oh, J; Kang, H; Lim, TH; Ko, BS; Yoo, KH; Lee, SH

doi:10.1001/jamanetworkopen.2023.7809

Cardiac arrest & resuscitation

Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest

JAMA Netw OpenPublished 3 Apr 2023Longitudinal population-based cohort study

Main finding · Long-term mortalityResultAdjusted hazard ratio 1.41 95% CI 1.17–1.70

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Authors' conclusion

In this study, among the patients who experienced OHCA, those diagnosed with depression or anxiety had higher long-term mortality rates than those without depression or anxiety.

Study context

Population: Patients hospitalized for nontraumatic out-of-hospital cardiac arrest (OHCA), 2005–2015, who survived ≥1 year, Korea
Participants: 2,373 patients

Exposure: Depression or anxiety vs Without depression or anxiety
Depression or anxietyn = 397
Without depression or anxietyn = 1,976reference
Outcome: Long-term cumulative mortality
Follow-up: Up to 14 years

Methodological detailsKorean National Health Insurance Service database, multivariate Cox proportional hazards regression

Korean National Health Insurance Service database
Multivariate Cox proportional hazards regression

Main finding

Long-term mortality

Adjusted hazard ratio

1.41

95% CI 1.17–1.70

Events by group

Depression or anxiety35.5%141 of 397

Without depression or anxiety27.0%534 of 1976

Depression or anxiety vs Without depression or anxiety

aHR 1.41 (95% CI 1.17–1.70)

As reported in the abstract

Observational data: associations, not effects.

Further findings

Outcome	← Lower risk vs without depression or anxiety ←→ Higher risk vs without depression or anxiety →	aHR (95% CI)
Long-term mortality by diagnosis (depression; anxiety)Depression vs Without depression or anxiety	0.512	1.44 (1.16–1.79)
Long-term mortality by diagnosis (depression; anxiety)Anxiety vs Without depression or anxiety	0.512	1.20 (0.94–1.53)
	0.512Adjusted hazard ratio (log scale)

Prevalence of depression or anxiety · within 1 year

Depression or anxiety: 397 (16.7%)
Depression: 251 (10.6%)
Anxiety: 227 (9.6%)

Original publication

Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest. JAMA Netw Open. Published 3 April 2023. doi:10.1001/jamanetworkopen.2023.7809

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