• Am J Emerg Med · Jan 2018

    Multicenter Study

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

    • Seungmin Jeong, Ki Ok Ahn, Sang Do Shin, Kyoung Jun Song, Joo-Yeong Kim, Eui Jung Lee, Yu Jin Lee, Ki Jeong Hong, and Young Sun Ro.
    • 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.
    • Am J Emerg Med. 2018 Jan 1; 36 (1): 100-104.

    ObjectiveWe 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.MethodsCase-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.ResultsA 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]).ConclusionsMLEs were associated with cardiac arrest occurrence, and the effect was modified by the elapsed time from the MLEs.Copyright © 2017 Elsevier Inc. All rights reserved.

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