February 28, 2022Scientific Reports40 citationsOpen Access
Mental health disorders and readmissions following acute myocardial infarction in the United States
Key Result
Comorbid mental health disorders, including major depression (HR 1.11) and schizophrenia (HR 1.56), independently increased the risk of 30-day all-cause readmission following acute myocardial infarction.
Study Design
Type
Observational (n=1,045,752)
Multicenter
Yes
Structured PICO
Do comorbid mental health disorders increase the risk of 30-day all-cause unplanned readmission in adults hospitalized for acute myocardial infarction?
P
Population
1,045,752 adult hospitalizations for acute myocardial infarction in the United States (National Readmission Database 2016-2017), mean age 67 ± 13 years, 37.6% female.
I
Intervention
Comorbid diagnosis of specific mental health disorders (major depression, bipolar disorders, anxiety disorders, schizophrenia/other psychotic disorders)
C
Comparator
No comorbid mental health disorders
O
Outcome
30-day all-cause unplanned readmissionhard clinical
Mental health disorders, particularly schizophrenia and bipolar disorders, are independently associated with a significantly higher risk of 30-day unplanned readmission following acute myocardial infarction.
Main Result
Effect estimate: HR 1.11 (95% CI 1.07-1.15)
Absolute Event Rate: 12.2% vs 10.3%
p-value: p=<0.001
Limitations
- Diagnosis of mental health disorders was based on administrative billing codes
- Database does not include detailed data on the severity and timing of diagnosis of comorbid mental health disorders
- Database does not include data on medical therapy, preventing adjustment for medical therapy in regression analysis
Abstract
Hospital readmissions following an acute myocardial infarction (MI) are associated with increased mortality and morbidity. The aim of this study was to investigate if there is a significant association between specific mental health disorders (MHD) and risk of hospital readmission after an index hospitalization for acute MI. We analyzed the U.S. National Readmission Database for adult acute MI hospitalizations from 2016 to 2017. Co-morbid diagnoses of MHD were obtained using appropriate ICD-10-CM diagnostic codes. The primary outcome of interest was 30-day all-cause unplanned readmission. Cox-regression analysis was used to identify the association of various MHD and risk of 30-day readmission adjusted for demographics, medical and cardiac comorbidities, and coronary revascularization. We identified a total of 1,045,752 hospitalizations for acute MI; patients had mean age of 67 ± 13 years with 37.6% female. The prevalence of any MHD was 15.0 ± 0.9%. After adjusting for potential confounders, comorbid diagnosis of major depression HR 1.11 (95% CI 1.07-1.15), bipolar disorders 1.32 (1.19-1.45), anxiety disorders 1.09 (1.05-1.13) and schizophrenia/other psychotic disorders 1.56 (1.43-1.69) were independently associated with higher risk of 30-day readmission compared to those with no comorbid MHD. We conclude that MHD are significantly associated with a higher independent risk of 30-day all-cause hospital readmissions among acute MI hospitalizations.