Depressive Symptoms Are Associated With Lower Patient Expectations for Recovery Following Cardiac Intensive Care Unit Admission.

BACKGROUND: Patients' expectations for recovery after cardiac intensive care unit (CICU) admission may influence their engagement in post-discharge care and overall recovery trajectory. While some evidence links expectations with clinical outcomes, few studies have examined how sociodemographic and clinical characteristics influence these expectations in CICU survivors. OBJECTIVE: To examine associations between sociodemographic and clinical characteristics and patients' expectations for recovery after a CICU stay. METHODS: This is a cross-sectional analysis of a longitudinal cohort of CICU survivors; the analysis was planned a priori. Participants (N = 98) were adults who completed the baseline survey within 45 days of CICU discharge. The outcome was expectations for recovery, measured on a 0 to 100 visual analog scale. Predictor variables included depressive symptoms, social support, income, intensive care unit (ICU) clinical context, length of stay, Sequential Organ Failure Assessment score, comorbidity burden, and sociodemographic characteristics. Multiple linear regression was used to assess associations. RESULTS: Participants had a mean age of 62.8 years (standard deviation = 13.0); 45.9% were female, 58.2% White, and 36.7% Black. Nearly half had an annual income <$49 000. Most (60.2%) had less than a college degree. The expectation for recovery score had a median of 80 (interquartile range: 64-95) and a mean of 76.4 (standard deviation = 22.9). Higher depressive symptoms (β = -1.08, P = .016) and lower income (β = -14.18, P = .014) were significantly associated with lower expectations. Other variables, including social support, ICU clinical context, the severity of acute illness, ICU length of stay, and comorbidities, were not significantly associated with expectations for recovery. CONCLUSIONS: Among CICU survivors, depressive symptoms and lower income were associated with lower expectations for recovery, whereas clinical characteristics were not. These findings suggest that psychosocial and socioeconomic contexts play a role in shaping recovery outlook. Future research is needed to better understand how expectations for recovery influence post-ICU recovery engagement and related outcomes.