PMID- 34887815
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211211
IS  - 1664-1078 (Print)
IS  - 1664-1078 (Electronic)
IS  - 1664-1078 (Linking)
VI  - 12
DP  - 2021
TI  - Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year 
      Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions.
PG  - 767915
LID - 10.3389/fpsyg.2021.767915 [doi]
LID - 767915
AB  - Background: Extensive research has reported that electroconvulsive therapy (ECT) 
      can be highly effective in approximately 80% of patients suffering from 
      depression. Its clinical use is mainly limited by historical objections and the 
      concern about unwanted adverse effects (AEs), including serious and potentially 
      life-threatening adverse events (pLTAEs), induced either by ECT or by anesthesia. 
      Objective risk estimation is, therefore, a decisive factor in determining an 
      indication for ECT. Methods: This paper presents a retrospective analysis of 
      3-year safety protocols and patient files of 157 patients who received a total of 
      3,106 ECT applications in a psychiatric inpatient setting at a psychiatric 
      community hospital. This patient group comprises 5.3% of inpatients admitted with 
      comparable diagnoses. Adverse events were analyzed from standardized safety 
      protocols and patient files with a focus on pLTAEs. Results: Adverse events were 
      reported for 30 (19.1%) of the 157 participants during 39 (6.1%) of 641 hospital 
      stays. Serious pLTAEs occurred during three electroconvulsive stimulations in 
      three patients, who needed action through the administration of medication or 
      mechanical respiration. No patient suffered permanent damage to health, and no 
      patient died. The incidence of these and other AEs was independent of sex, age, 
      and diagnosis of patients, and anesthesia medication. Minor AEs occurred more 
      often with higher stimulus doses and an increasing number of treatments. 
      Conclusion: The low incidence rate of 0.097% of serious pLTAEs that require 
      medical action may allow the conclusion that ECT is a rather safe treatment when 
      performed in a controlled setting. The beneficial risk profile of ECT performed 
      in the standard care of psychiatric hospitals suggests a more generous indication 
      of this treatment method. We recommend that ECT facilities collect individual 
      safety data to allow a reliable judgment of their institutional ECT risk profile.
CI  - Copyright (c) 2021 Hajak, Hajak, Ziegelmayer, Grimm and Trapp.
FAU - Hajak, Vivien L
AU  - Hajak VL
AD  - Department of Psychology, Medical School Berlin, Berlin, Germany.
AD  - Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social 
      Foundation Bamberg, Bamberg, Germany.
FAU - Hajak, Goran
AU  - Hajak G
AD  - Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social 
      Foundation Bamberg, Bamberg, Germany.
FAU - Ziegelmayer, Christoph
AU  - Ziegelmayer C
AD  - Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social 
      Foundation Bamberg, Bamberg, Germany.
FAU - Grimm, Simone
AU  - Grimm S
AD  - Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social 
      Foundation Bamberg, Bamberg, Germany.
AD  - Department of Psychiatry, Charite, Campus Benjamin Franklin, Berlin, Germany.
FAU - Trapp, Wolfgang
AU  - Trapp W
AD  - Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social 
      Foundation Bamberg, Bamberg, Germany.
AD  - Department of Psychology, Otto-Friedrich-University of Bamberg, Bamberg, Germany.
AD  - Department of Psychology, University of Applied Sciences, Bamberg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20211123
PL  - Switzerland
TA  - Front Psychol
JT  - Frontiers in psychology
JID - 101550902
PMC - PMC8650631
OTO - NOTNLM
OT  - ECT
OT  - depression
OT  - electroconvulsive therapy
OT  - live threatening adverse events
OT  - neurostimulation
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/12/11 06:00
MHDA- 2021/12/11 06:01
PMCR- 2021/11/23
CRDT- 2021/12/10 06:41
PHST- 2021/08/31 00:00 [received]
PHST- 2021/10/20 00:00 [accepted]
PHST- 2021/12/10 06:41 [entrez]
PHST- 2021/12/11 06:00 [pubmed]
PHST- 2021/12/11 06:01 [medline]
PHST- 2021/11/23 00:00 [pmc-release]
AID - 10.3389/fpsyg.2021.767915 [doi]
PST - epublish
SO  - Front Psychol. 2021 Nov 23;12:767915. doi: 10.3389/fpsyg.2021.767915. eCollection 
      2021.