{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T18:35:43Z","timestamp":1786818943465,"version":"build-2736575974"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi230254-4\"><jats:title>Importance<\/jats:title><jats:p>The recent American Heart Association guidelines added a sixth link in the chain of survival highlighting recovery and emphasized the importance of psychiatric outcome and recovery for survivors of out-of-hospital cardiac arrest (OHCA). The prevalence of psychiatric disorders among this population was higher than that in the general population.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230254-5\"><jats:title>Objective<\/jats:title><jats:p>To examine the prevalence of depression or anxiety and the association of these conditions with long-term mortality among individuals who survive OHCA.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230254-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>A longitudinal population-based cohort study was conducted to analyze long-term prognosis in patients hospitalized for OHCA between January 1, 2005, and December 31, 2015, who survived for 1 year or longer. Patients with cardiac arrest due to traumatic or nonmedical causes, such as injuries, poisoning, asphyxiation, burns, or anaphylaxis, were excluded. Data were extracted on depression or anxiety diagnoses in this population within 1 year from the database of the Korean National Health Insurance Service and analyzed April 7, 2022, and reanalyzed January 19 to 20, 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230254-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Follow-up data were obtained for up to 14 years, and the primary outcome was long-term cumulative mortality. Long-term mortality among patients with and without a diagnosis of depression or anxiety were evaluated.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230254-8\"><jats:title>Results<\/jats:title><jats:p>The analysis included 2373 patients; 1860 (78.4%) were male, and the median age was 53.0 (IQR, 44.0-62.0) years . A total of 397 (16.7%) patients were diagnosed with depression or anxiety, 251 (10.6%) were diagnosed with depression, and 227 (9.6%) were diagnosed with anxiety. The incidence of long-term mortality was significantly higher in the group diagnosed with depression or anxiety than in the group without depression or anxiety (141 of 397 [35.5%] vs 534 of 1976 [27.0%]; <jats:italic>P<\/jats:italic>\u2009=\u2009.001). With multivariate Cox proportional hazards regression analysis, the adjusted hazard ratio of long-term mortality for total patients with depression or anxiety was 1.41 (95% CI, 1.17-1.70); depression, 1.44 (95% CI, 1.16-1.79); and anxiety, 1.20 (95% CI, 0.94-1.53).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230254-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>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. These findings suggest that psychological and neurologic rehabilitation intervention for survivors of OHCA may be needed to improve long-term survival.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.7809","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T15:04:52Z","timestamp":1681311892000},"page":"e237809","source":"Crossref","is-referenced-by-count":22,"title":["Analysis of Anxiety or Depression and Long-term Mortality Among Survivors of Out-of-Hospital Cardiac Arrest"],"prefix":"10.1001","volume":"6","author":[{"given":"Juncheol","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongil","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaehoon","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunggoo","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Ho","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byuk Sung","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Hun","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Hwan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"issue":"1","key":"zoi230254r1","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s13613-015-0064-x","article-title":"Breakthrough in cardiac arrest: reports from the 4th Paris International Conference.","volume":"5","author":"Kudenchuk","year":"2015","journal-title":"Ann Intensive Care"},{"key":"zoi230254r2","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.resuscitation.2016.06.004","article-title":"EuReCa ONE-27 Nations, ONE Europe, ONE Registry: a prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe.","volume":"105","author":"Gr\u00e4sner","year":"2016","journal-title":"Resuscitation"},{"issue":"14","key":"zoi230254r3","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1093\/eurheartj\/ehu240","article-title":"Improved outcome in Sweden after out-of-hospital cardiac arrest and possible association with improvements in every link in the chain of survival.","volume":"36","author":"Str\u00f6ms\u00f6e","year":"2015","journal-title":"Eur Heart J"},{"key":"zoi230254r4","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.ejim.2019.11.024","article-title":"Long term clinical outcomes in survivors after out-of-hospital cardiac arrest.","volume":"74","author":"Rey","year":"2020","journal-title":"Eur J Intern Med"},{"issue":"16, suppl 2","key":"zoi230254r5","doi-asserted-by":"publisher","first-page":"S366","DOI":"10.1161\/CIR.0000000000000916","article-title":"Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.","volume":"142","author":"Panchal","year":"2020","journal-title":"Circulation"},{"issue":"6","key":"zoi230254r6","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/j.resuscitation.2014.02.008","article-title":"The psychosocial outcomes of anoxic brain injury following cardiac arrest.","volume":"85","author":"Wilson","year":"2014","journal-title":"Resuscitation"},{"issue":"3","key":"zoi230254r7","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1007\/s00134-021-06608-7","article-title":"Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock.","volume":"48","author":"Bougouin","year":"2022","journal-title":"Intensive Care Med"},{"key":"zoi230254r8","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.ajem.2022.05.017","article-title":"Mid-term (30- to 90-day) neurological changes in out-of-hospital cardiac arrest patients: a nationwide retrospective study (the JAAM-OHCA registry).","volume":"58","author":"Naito","year":"2022","journal-title":"Am J Emerg Med"},{"issue":"3","key":"zoi230254r9","doi-asserted-by":"publisher","first-page":"225","DOI":"10.15441\/ceem.19.071","article-title":"Characteristics and outcomes of public bath-related out-of-hospital cardiac arrests in South Korea.","volume":"7","author":"Yoo","year":"2020","journal-title":"Clin Exp Emerg Med"},{"issue":"4","key":"zoi230254r10","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1007\/s00134-021-06368-4","article-title":"European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care.","volume":"47","author":"Nolan","year":"2021","journal-title":"Intensive Care Med"},{"key":"zoi230254r11","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.resuscitation.2020.04.002","article-title":"Health-related quality of life after surviving an out-of-hospital compared to an in-hospital cardiac arrest: a Swedish population-based registry study.","volume":"151","author":"Dj\u00e4rv","year":"2020","journal-title":"Resuscitation"},{"key":"zoi230254r12","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.resuscitation.2015.09.389","article-title":"Anxiety and depression among out-of-hospital cardiac arrest survivors.","volume":"97","author":"Lilja","year":"2015","journal-title":"Resuscitation"},{"issue":"7","key":"zoi230254r13","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1016\/j.resuscitation.2012.11.021","article-title":"Anxiety, depression, and PTSD following cardiac arrest: a systematic review of the literature.","volume":"84","author":"Wilder Schaaf","year":"2013","journal-title":"Resuscitation"},{"issue":"S","key":"zoi230254r14","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.15441\/ceem.21.021","article-title":"Steering Committee of the 2020 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. 2020 Korean Guidelines for cardiopulmonary resuscitation\u2014part 1: update process and highlights.","volume":"8","author":"Hwang","year":"2021","journal-title":"Clin Exp Emerg Med"},{"issue":"6","key":"zoi230254r15","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-021729","article-title":"Well-being among survivors of out-of-hospital cardiac arrest: a cross-sectional retrospective study in Sweden.","volume":"8","author":"Viktorisson","year":"2018","journal-title":"BMJ Open"},{"key":"zoi230254r16","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.resuscitation.2021.11.023","article-title":"Prevalence of anxiety, depression, and post-traumatic stress disorder after cardiac arrest: a systematic review and meta-analysis.","volume":"170","author":"Yaow","year":"2022","journal-title":"Resuscitation"},{"issue":"5","key":"zoi230254r17","doi-asserted-by":"publisher","first-page":"395","DOI":"10.4093\/dmj.2014.38.5.395","article-title":"Background and data configuration process of a nationwide population-based study using the Korean National Health Insurance system.","volume":"38","author":"Song","year":"2014","journal-title":"Diabetes Metab J"},{"issue":"40","key":"zoi230254r18","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2020.35.e360","article-title":"Incidence and mortality rates of thoracic aortic dissection in Korea\u2014inferred from the Nationwide Health Insurance claims.","volume":"35","author":"Lee","year":"2020","journal-title":"J Korean Med Sci"},{"key":"zoi230254r19","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.resuscitation.2022.02.005","article-title":"Long-term prognosis and causes of death among survivors after out-of-hospital cardiac arrest: a population-based longitudinal study.","volume":"173","author":"Cho","year":"2022","journal-title":"Resuscitation"},{"issue":"12","key":"zoi230254r20","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1016\/j.jclinepi.2004.03.012","article-title":"New ICD-10 version of the Charlson Comorbidity Index predicted in-hospital mortality.","volume":"57","author":"Sundararajan","year":"2004","journal-title":"J Clin Epidemiol"},{"issue":"11","key":"zoi230254r21","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data.","volume":"43","author":"Quan","year":"2005","journal-title":"Med Care"},{"key":"zoi230254r22","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.resuscitation.2019.12.017","article-title":"Trapped in a disrupted normality: survivors\u2019 and partners\u2019 experiences of life after a sudden cardiac arrest.","volume":"147","author":"Whitehead","year":"2020","journal-title":"Resuscitation"},{"issue":"12","key":"zoi230254r23","doi-asserted-by":"publisher","first-page":"e654","DOI":"10.1161\/CIR.0000000000000747","article-title":"Sudden cardiac arrest survivorship: a scientific statement from the American Heart Association.","volume":"141","author":"Sawyer","year":"2020","journal-title":"Circulation"},{"issue":"3","key":"zoi230254r24","doi-asserted-by":"publisher","first-page":"E10","DOI":"10.1097\/JCN.0000000000000467","article-title":"A meta-ethnography of out-of-hospital cardiac arrest survivors\u2019 meanings on life and death.","volume":"33","author":"Aristidou","year":"2018","journal-title":"J Cardiovasc Nurs"},{"issue":"2","key":"zoi230254r25","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1097\/CCM.0b013e3181fd66e5","article-title":"Long-term complications of critical care.","volume":"39","author":"Desai","year":"2011","journal-title":"Crit Care Med"},{"issue":"1","key":"zoi230254r26","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1186\/s13054-018-2223-6","article-title":"Anxiety, depression and post traumatic stress disorder after critical illness: a UK-wide prospective cohort study.","volume":"22","author":"Hatch","year":"2018","journal-title":"Crit Care"},{"issue":"3","key":"zoi230254r27","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/S0165-0327(01)00413-X","article-title":"Excess mortality in depression: a meta-analysis of community studies.","volume":"72","author":"Cuijpers","year":"2002","journal-title":"J Affect Disord"},{"issue":"4","key":"zoi230254r28","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.jpsychores.2015.01.014","article-title":"Associations between depression and all-cause and cause-specific risk of death: a retrospective cohort study in the Veterans Health Administration.","volume":"78","author":"Zivin","year":"2015","journal-title":"J Psychosom Res"},{"issue":"12","key":"zoi230254r29","doi-asserted-by":"publisher","first-page":"1350","DOI":"10.1161\/CIR.0000000000000019","article-title":"Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association.","volume":"129","author":"Lichtman","year":"2014","journal-title":"Circulation"},{"issue":"9","key":"zoi230254r30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0074393","article-title":"Depressive symptoms and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based longitudinal study examining health behaviors and health care interventions.","volume":"8","author":"Larsen","year":"2013","journal-title":"PLoS One"},{"issue":"2","key":"zoi230254r31","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1016\/j.chest.2020.07.022","article-title":"Long-term disabilities of survivors of out-of-hospital cardiac arrest: the Hanox study.","volume":"159","author":"Peskine","year":"2021","journal-title":"Chest"},{"issue":"11","key":"zoi230254r32","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.1097\/CCM.0000000000004586","article-title":"Society of Critical Care Medicine\u2019s international consensus conference on prediction and identification of long-term impairments after critical illness.","volume":"48","author":"Mikkelsen","year":"2020","journal-title":"Crit Care Med"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2803736\/lee_2023_oi_230254_1680705720.96289.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T15:04:55Z","timestamp":1681311895000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2803736"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,12]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.7809","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,12]]}}}