423 Fatigue three months after out-of-hospital cardiac arrest and its association with early cognitive impairment and psychopathology

Purpose: Fatigue is the most prevalent problem after out-of-hospital cardiac arrest (OHCA), reported by over 70% of survivors and
leading to difficulties returning to work, home and everyday activities.
The causes of fatigue are complex but understanding the early factors
leading to fatigue could help develop effective interventions. Hence,
this study aimed to investigate the prevalence of fatigue three months
after OHCA and its association with early cognitive impairment and
psychopathology.
Material and methods: This was a multicenter prospective cohort
study. During hospitalisation (median 5 days after OHCA), Danish
OHCA survivors were screened for cognitive impairment using the
Montreal Cognitive Assessment (MoCA), and self-reported symptoms
of anxiety, depression and traumatic distress using the Hospital
Anxiety and Depression Scale and the Impact of Event Scale-revised. At
three-month follow-up, fatigue severity was evaluated using the
Fatigue Severity Scale (FSS) (range: 9–63 points; cut-off >36 indicates
pathological fatigue). Logistic regression models were applied to
investigate associations.
Results: Overall, n = 173 survivors were included (mean age 63
years, 82% male). At the three-month follow-up, the median FSS score
was 29 points (IQR 18–45) and 36% of survivors had fatigue. Higher
fatigue was significantly associated with worse anxiety (OR 2.55, 95%
CI: 1.23–5.26), depression (OR 3.80, 95% CI: 1.65–8.76), and traumatic
distress (OR 5.25, 95% CI: 2.34–11.74), but not cognitive impairment
(OR 1.2, 95% CI: 0.64–2.24).
Conclusions: A third of OHCA survivors in this study had fatigue at
three-month follow-up associated with symptoms of psychopathology, particularly traumatic distress. This supports the need for
routine screening for fatigue and psychopathology and further
research to determine effective treatment interventions. We found a
lower proportion of survivors with fatigue than in previous studies.
However, the FSS cut-off used was established for stroke patients and
may not be sensitive to OHCA-related fatigue.