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Anxiety Predicts Mortality in ICD Patients: Results from the Cross‐Sectional National CopenHeart ICD Survey with Register Follow‐Up
Author(s) -
KIKKENBORG BERG SELINA,
CASPAR THYGESEN LAU,
HASTRUP SVENDSEN JESPER,
VINGGAARD CHRISTENSEN ANNE,
ZWISLER ANNDORTHE
Publication year - 2014
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12490
Subject(s) - medicine , anxiety , depression (economics) , quality of life (healthcare) , implantable cardioverter defibrillator , population , cross sectional study , mental health , odds ratio , icd 10 , hospital anxiety and depression scale , physical therapy , psychiatry , environmental health , nursing , pathology , economics , macroeconomics
Background Although highly effective in preventing arrhythmic death, patients receiving an implantable cardioverter defibrillator (ICD) may still experience psychological difficulties such as anxiety, depression, and reduced quality of life. The objectives of this study were to describe patient‐reported outcomes among ICD patients: (1) compared to a matched healthy population, (2) compared by ICD indication, (3) factors predicting patient‐reported outcomes, and (4) if patient‐reported outcomes predicted mortality. Methods The study was a mailed survey to an unselected group of patients 18+ years old receiving ICD between January 1, 2011 and June 30, 2011 (n = 499). The following instruments were used: SF‐36, Hospital Anxiety and Depression Scale, HeartQoL, EQ‐5D, and the Multidimensional Fatigue Inventory. Results The response rate was 72%. Mean age was 65.5 years and 82% patients were males. Fifty‐three percent of patients had primary prevention indication ICD. Compared to an age‐ and gender‐matched population without disease, the ICD population had worse mental health (55.0 vs 51.7 points) and physical health (52.6 vs 41.9 points). Patients with primary prevention indication had lower levels of perceived health, quality of life, and fatigue; for example, physical health 39.8 versus 44.3 points, compared to secondary prevention indication. Anxiety, poor perceived health, fatigue, and low quality of life were all predictors of mortality, anxiety being the strongest with an adjusted odds ratio of 4.17 (1.49; 11.66). Conclusions Patients with primary prevention ICD had lower levels of perceived health, quality of life, and more fatigue. Anxiety, poor perceived health, fatigue, and low quality of life were all predictors of mortality.