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Increased Prevalence of Psychosis in Patients Who Get Admitted with Acute Myocardial Infarction with Worse Outcomes

Published online by Cambridge University Press:  23 March 2020

Z. Mansuri ,
S. Patel ,
P. Patel ,
O. Jayeola ,
A. Das ,
J. Shah ,
M.H. Gul ,
K. Karnik ,
A. Ganti  and
K. Shah
Z. Mansuri
Affiliation:
Texas Tech University Health Sciences Center Permian Basin Campus, Psychiatry, Odessa, TX, USA
S. Patel
Affiliation:
Icahn School of Medicine at Mount Sinai, Public Health, New York, USA
P. Patel
Affiliation:
Windsor University School of Medicine, Public Health, Monee, USA
O. Jayeola
Affiliation:
Drexel University School of Public Health, Public Health, Philadelphia, USA
A. Das
Affiliation:
Florida Hospital, Internal Medicine, Orlando, USA
J. Shah
Affiliation:
Pramukhswami Medical College, Internal Medicine, Karamsad, USA
M.H. Gul
Affiliation:
St. Louis University Hospital, Nephrology, St. Louis, USA
K. Karnik
Affiliation:
Children's Hospital of San Antonio, Public Health, San Antonio, USA
A. Ganti
Affiliation:
Suburban Medical Center, Internal Medicine, Schaumburg, USA
K. Shah
Affiliation:
Kentucky University, Public Health, Bowling Green, USA

Abstract

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Objective

To determine trends and impact on outcomes of acute myocardial infarction (AMI) in patients with pre-existing psychosis.

Background

While post-AMI psychosis has been extensively studied, contemporary studies including temporal trends on impact of pre-AMI Psychosis on AMI and post-AMI outcomes are lacking.

Methods

We used Nationwide Inpatient Sample (NIS) from Healthcare Cost and Utilization Project(HCUP) from 2002 to 2012. We identified AMI and psychosis as primary and secondary diagnosis respectively using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD9CM) codes, and Cochrane-Armitage trend test and multivariate regression to generate adjusted odds ratios (aOR).

Results

We analyzed total of 7,174,274 AMI hospital admissions from 2002 to 2012 of which 1.77% had psychosis. Proportion of hospitalizations with psychosis increased from 6.94% to 11.85% (P-trend < 0.001). Utilization of percutaneous coronary intervention (PCI) was lower in patients with psychosis (29.98% vs. 40.36%, P < 0.001). Utilization of coronary artery bypass grafting (CABG) was lower in patients with psychosis (8.01% vs. 9.18%, P < 0.001). In-hospital mortality was significantly lower in patients with psychosis (aOR 0.677; 95% CI 0.630–0.727; P < 0.001) but discharge to specialty care higher (aOR 1.870; 95%CI 1.786–1.958; P < 0.001). In addition, median length of hospitalization (3.77 vs. 2.90 days; P < 0.001) was higher in hospitalizations with psychosis.

Conclusions

Our study displayed increasing proportion of patients with psychosis admitted due to AMI in last decade with lower mortality but higher morbidity post-infarction, and significantly less utilization of PCI and CABG. There was also increased length of stay patients with MDD. There is need to explore reasons behind this disparity in outcomes and PCI and CABG utilization to improve post-AMI outcomes in this vulnerable population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Walk: Epidemiology and social psychiatry
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. s247
Copyright
Copyright © European Psychiatric Association 2017
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