Abstract 4360114: Psychosocial and Socioeconomic Contexts Predict Expectations for Recovery following Cardiac Intensive Care Unit Stay

Abstract

Background: Patients’ expectations for recovery after cardiac intensive care unit (CICU) hospitalization may influence their engagement in post-discharge care and overall recovery trajectory. While some evidence links expectations with recovery outcomes, few studies have examined how sociodemographic and clinical factors influence these expectations in CICU survivors. Research Question and Hypotheses: This study examined associations between sociodemographic and clinical characteristics and patients’ expectations for recovery after a CICU stay. We hypothesized that lower expectations would be associated with greater psychosocial vulnerability and severe illness. Methods: This cross-sectional analysis was nested within the Wellness and Needs of Men and Women after a Cardiac Intensive Care Unit Stay (WellNOW) Study, a longitudinal cohort of CICU survivors. 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 0-100 visual analog scale. Predictor variables included depressive symptoms (PHQ-8), social support (Enriched Social Support Instrument), income, ICU clinical context (surgical vs medical), length of stay, Sequential Organ Failure Assessment score (SOFA), comorbidity burden (Charlson Comorbidity Index), and sociodemographic characteristics. Multiple linear regression was used to assess associations. Results: Participants had a mean age of 62.8 years (SD = 13.0); 45.9% were female, 58.2% White, and 36.7% Black. Nearly half had annual income <$49,000, and 54.6% reported financial strain. Most (60.2%) had less than a college degree. Expectation for recovery score had a median of 80 (IQR, 64-95) and a mean of 76.4 (SD = 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, SOFA score, ICU length of stay, and comorbidities, were not significantly associated with expectations for recovery. Conclusion: Among CICU survivors, depressive symptoms and lower income were associated with lower expectations for recovery, whereas clinical factors 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.