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Am J Emerg Med. 2018 Jan;36(1):100-104. doi: 10.1016/j.ajem.2017.07.039. Epub 2017 Jul 13.

Association of recent major psychological stress with cardiac arrest: A case-control study.

Author information

1
Department of Preventive Medicine, Seoul National University Graduate School of Public Health, Republic of Korea; Laboratory of emergency medical services, Bio-medical research institute, Seoul National University Hospital, Republic of Korea.
2
Department of Emergency Medicine, Myoungji Hospital, Republic of Korea; Laboratory of emergency medical services, Bio-medical research institute, Seoul National University Hospital, Republic of Korea. Electronic address: arendt75@gmail.com.
3
Department of Emergency Medicine, Seoul National University College of Medicine, Republic of Korea; Laboratory of emergency medical services, Bio-medical research institute, Seoul National University Hospital, Republic of Korea.
4
Department of Emergency Medicine, Korea University Ansan Hospital, Republic of Korea; Laboratory of emergency medical services, Bio-medical research institute, Seoul National University Hospital, Republic of Korea.
5
Department of Emergency Medicine, Korea University Anam Hospital, Republic of Korea; Laboratory of emergency medical services, Bio-medical research institute, Seoul National University Hospital, Republic of Korea.
6
Department of Emergency Medicine, Inha University Hospital, Republic of Korea; Laboratory of emergency medical services, Bio-medical research institute, Seoul National University Hospital, Republic of Korea.
7
Department of Emergency Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Republic of Korea; Laboratory of emergency medical services, Bio-medical research institute, Seoul National University Hospital, Republic of Korea.
8
Laboratory of emergency medical services, Bio-medical research institute, Seoul National University Hospital, Republic of Korea.

Abstract

OBJECTIVE:

We hypothesized that major psychological stress can be a risk factor for cardiac arrest and that effects are modified by elapsed time from specific stressful events.

METHODS:

Case-control study was conducted using database for cardiac arrest and emergency department (ED) visiting. Cases included adult patients with cardiac arrest with presumed cardiac etiology. Controls were matched with sex and age and visiting day from unintentional injured patients in same ED. The occurrence of 9 major life events (MLEs) such as a divorce within 1year was used as a proxy measure of major psychological stress. A multivariable conditional logistic regression conducted to estimate the effect of MLEs on the risk of cardiac arrest according to the elapsed time from the MLEs.

RESULTS:

A total of 95 patients with cardiac arrest and 95 controls were assessed. In the case group, a total of 58 MLEs occurred, while 33 MLEs occurred in the control group during the same period. Recent MLEs were associated with a higher risk of sudden cardiac arrest (AOR 2.26 [95% CI:1.01-5.03]). The AORs of cardiac arrest were 4.65 (95% CI, 1.38-15.67) and 7.02 (95% CI, 2.03-24.48) among participants experiencing MLEs within the last 0-3months and those experiencing MLEs within the last 0-6months, respectively. Cardiac arrest and MLEs in participants experiencing MLEs between 7 and 12months prior showed no association (AOR 4.76 [95% CI, 0.97-18.36]).

CONCLUSIONS:

MLEs were associated with cardiac arrest occurrence, and the effect was modified by the elapsed time from the MLEs.

KEYWORDS:

Cardiac Arrest; Life change event; Precipitating factors

PMID:
28739389
DOI:
10.1016/j.ajem.2017.07.039
[Indexed for MEDLINE]

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