Abstract Details

Title Association Between Cognitive Aversions and Engagement in Physical Activity Within 1-year of Survival after Cardiac Arrest

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) Neurocritical Care Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 010

Objective

To examine aversive cognitions and engagement in physical activity (PA) among cardiac arrest (CA) survivors.

Background

It is well known that PA reduces the risk of recurrent cardiovascular disease events. We hypothesize that aversive cognitions about physical activity due to the fear of trauma-related bodily sensations may lead to poor engagement in PA after cardiac arrest.

Design/Methods We prospectively enrolled 58 adults after in or out-of-hospital CA between 9/2015-8/2018 at a high-volume, major academic center. Aversive cognitions about PA were measured with the following items: 1) “I am anxious when I think about doing PA at home;” 2) “I worry that doing PA at home will trigger another cardiac event;” 3) “I fear that I won’t know what is and isn’t safe;” 4) “I worry that I will die.” Patients responded using a 4-point Likert scale and “extremely” or “moderately” responses were classified as having aversive cognitions for each item. Items were adapted from the Anxiety Sensitivity Index.

Results

Of 58 patients included (50% women, 52% minorities, average age 55±17 years) greater than 2/3 of respondents reported at least one concern about PA. Many (62% at discharge and 65% at 12 months) are not engaged in recommended levels of physical activity. Patients who reported at least one concern were almost 4 times more likely (vs those who reported no concerns) to have NOT engaged in PA at home since CA (OR= 4 (1.3-14) P=0.01), after adjusting for age, sex, and time since event. Fear of death was independently associated with low engagement after adjusting for age, sex, and time since event (OR 1.9 (1-3.7) P=0.05).

Conclusions Survivors of CA frequently experience PA-induced anxiety and avoid PA because of fear of recurrence or death. PA avoidance as an underlying mechanism by which psychological distress worsens prognosis in CA patients should be tested prospectively.

Authors/Disclosures
PRESENTER	No disclosure on file
Michelle Chee, MD	Dr. Chee has nothing to disclose.
David J. Roh, MD (Columbia University Medical Center)	Dr. Roh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Portola Pharmaceuticals.
Soojin Park, MD	Dr. Park has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurocritical Care. The institution of Dr. Park has received research support from National Institutes of Health.
Jan Claassen, MD, PhD (Columbia University College of Physicians & Surgeons)	Dr. Claassen has stock in iCE Neurosystems. The institution of Dr. Claassen has received research support from NINDS. The institution of Dr. Claassen has received research support from McDonnel Foundation. Dr. Claassen has received publishing royalties from a publication relating to health care. Dr. Claassen has received publishing royalties from a publication relating to health care.
Mitchell S. Elkind, MD, MS, FAAN	Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy.
	No disclosure on file
Sachin Agarwal, MD, MPH (Columbia University Med Center)	Dr. Agarwal has nothing to disclose.

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