LONG-TERM PHYSICAL FUNCTIONING AND PSYCHOSOCIAL ADJUSTMENT IN SURVIVORS OF SUDDEN CARDIAC DEATH

Objective: To identify and describe a range of functional health outco mes in a sample of sudden cardiac death survivors. Design: Cross-secti onal survey. Setting: Northern California tertiary medical center. Sub jects: Sixty-one sudden cardiac death survivors at least 6 months but not more than 4 years after cardiac arrest. Subjects were excluded if they had uncontrolled congestive heart failure, unstable angina, other debilitating cardiac or concomitant illness, or evident cognitive def icits. Methods: Chart reviews, patient interviews, and a standardized questionnaire.Results: Survivors reported significantly poorer physica l functioning than normal subjects (p < 0.001), although none were lim ited in self-care. Mental Health Index Scores and subscale scores for psychologic well-being were within established norms. However, mean sc ores for the psychologic distress subscale were elevated (p < 0.001). Initial work return was 72%. Of the 37 (61%) survivors who were sexual ly active before their arrests, 78% resumed coitus. Twenty-five surviv ors reported mild to moderately severe impairments in memory or other cognitive skills. Poor physical functioning was associated with illnes s severity, change in work status, and increased anxiety. Psychologic distress was associated with change in work status and poor physical f unctioning, but not illness severity. Conclusions: Despite significant decreases in physical functioning and reports of mild to moderately s evere cognitive impairments, only a minority of sudden cardiac death s urvivors are severely psychologically distressed. Illness severity is a strong predictor of physical functioning, but its contribution to ps ychologic distress is indirect, acting largely through the aegis of po or physical functioning and loss of prearrest work status.