Impact of cardiogenic shock on quality of life and post-traumatic stress disorder
L Scheufele, S Beke Aschoff, J Aydin-Rosu, C W von Musil, L Pilsenbacher, J Gmeiner, J Fischer, S Kaeaeb, S Massberg, C SchererAbstract
Introduction
Cardiogenic shock (CS) requiring intensive care unit (ICU) treatment is associated with high mortality. Survivors frequently experience long-term physical and psychological impairments, including post-traumatic stress disorder (PTSD). This study aimed to investigate the quality of life (QoL) and mental health (MH) outcomes of patients surviving ICU treatment for CS.
Methods
A retrospective analysis was conducted for patients treated for CS in the ICU between 2010 and 2023. Health-related QoL and MH were assessed after ICU discharge using the Short Form-36 (SF-36), Post-Traumatic Stress Syndrome 14-item questionnaire (PTSS-14), and the EuroQol 5-Dimension (EQ-5D). Subgroup analyses were performed to identify predictors of impaired QoL and PTSD symptoms.
Results
A total of 285 patients with a mean age was 62 ± 14 years were included. 44% of patients presented with a maximum SCAI shock stage C. Mean lactate at admission was 3.3 ± 3 mmol/L. Mean PTSS-14 score was 30 ± 15, with 21.4% of patients exceeding the diagnostic cutoff (>40), indicating clinically relevant PTSD symptoms. Mean EQ5DTTO was 0.88 ± 0.2 and mean EQ5DRCW was 0.85 ± 0.2. SF-36 revealed significant impairments, particularly in role physical (13 ± 31), role emotional (11 ± 32), and mental health (39 ± 11), with significantly lower scores compared to age-matched German normative values. Multivariable analysis identified higher age and use of mechanical circulatory support (MCS) as independent predictors of reduced EQ-5D scores. Non–acute myocardial infarction (non-AMI) CS was associated with significantly higher PTSS-14 scores.
Conclusion
Survivors of CS requiring ICU treatment exhibit a considerable burden of PTSD symptoms and impaired health-related QoL. Older age, MCS use, and non-AMI aetiology are associated with worse outcomes. These findings underscore the importance of structured post-ICU follow-up and multidisciplinary rehabilitation strategies to improve long-term recovery.