July 1, 2026The International Journal of Psychiatry in Medicine

Psychiatric Comorbidity in Heart Failure: Associations With Length of Stay, Costs, and Mortality in a National Cohort

Q: What are the key findings of this study?

Anxiety increased length of stay and costs in heart failure patients, while depression (30-day OR 0.86) and bipolar disorder (OR 0.66) were associated with lower mortality (all P<0.001).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Heart Failure (n=31886859). Intervention: Psychiatric comorbidities (depression, anxiety, bipolar disorder, schizophrenia, PTSD, SUD) vs. Heart failure patients without the specific psychiatric comorbidity. Primary outcome: Index length of stay, inflation-adjusted costs, and in-hospital mortality during readmissions within 30 days and up to 1 year after discharge (OR 0.86, p=<0.001).

Q: What question did this study set out to answer?

This study evaluates how specific psychiatric comorbidities affect length of stay, hospital costs, and mortality rates in heart failure patients.

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Key result

Anxiety increases HF hospital stays and costs, while depression is linked to ~14% lower mortality.

OR 0.86
P<0.001
n=31,886,859

Why the study?

To evaluate how specific psychiatric comorbidities relate to index length of stay, hospital costs, and in-hospital mortality during readmissions after heart failure hospitalization.

How do specific psychiatric comorbidities affect length of stay, hospital costs, and mortality in adults hospitalized for heart failure?

Population

31,886,859 weighted HF hospitalizations among adults

Comparison

Specific psychiatric comorbidities vs absence of those comorbidities

Design

Retrospective cohort study

Follow-up

Up to 1 year after discharge

Authors

ACAustin A. Charles KTKyle E Thurmann PEPeter L. Ernst

Discussion

Member takes

Overview

Anxiety was associated with longer heart failure stays; hypothesis-generating for integrated psychiatric care before practice change.

Key Points

This study evaluates how specific psychiatric comorbidities affect length of stay, hospital costs, and mortality rates in heart failure patients.
Retrospective cohort study using 2016-2022 Nationwide Readmissions Database
Included adults with a principal heart failure diagnosis
Used survey-weighted multivariable models to adjust for demographics and comorbidity burden.
Anxiety increased length of stay by 0.88 days (P < 0.001) and costs by $2779 (P < 0.001) without affecting mortality.
Higher mortality odds were associated with lower rates in patients with depression (30-day OR = 0.86), bipolar disorder (0.66), and others (all P < 0.001).
Bipolar disorder associated with the largest cost reduction of $1320 (P < 0.001) compared to patients without it.

Study Design

Type

Cohort (n=31,886,859)

Multicenter

Yes

Structured PICO

How do specific psychiatric comorbidities affect length of stay, hospital costs, and mortality in adults hospitalized for heart failure?

Population

31,886,859 weighted hospitalizations of adults with a principal heart failure diagnosis, evaluated for the impact of psychiatric comorbidities on outcomes up to 1 year after discharge.

Exposure

Presence of specific psychiatric comorbidities (depression, anxiety, bipolar disorder, schizophrenia/psychotic disorders, post-traumatic stress disorder [PTSD], and substance use disorder [SUD])

Comparator

Heart failure patients without the specific psychiatric comorbidity

Outcome

Index length of stay (LOS), inflation-adjusted costs, and in-hospital mortality during readmissions within 30 days and up to 1 year after dischargehard clinical

Main Result

Odds Ratio: 0.86

p-value: p=<0.001

In patients hospitalized for heart failure, anxiety is associated with increased hospital utilization and costs, whereas other psychiatric comorbidities like depression and bipolar disorder are paradoxically associated with lower in-hospital mortality during readmissions.

Cite This Study

Charles et al. (2026) conducted a cohort in Heart Failure (n=31,886,859). Psychiatric comorbidities (depression, anxiety, bipolar disorder, schizophrenia, PTSD, SUD) vs. Heart failure patients without the specific psychiatric comorbidity was evaluated on Index length of stay, inflation-adjusted costs, and in-hospital mortality during readmissions within 30 days and up to 1 year after discharge (OR 0.86, p=<0.001). Anxiety increased length of stay and costs in heart failure patients, while depression (30-day OR 0.86) and bipolar disorder (OR 0.66) were associated with lower mortality (all P<0.001).

synapsesocial.com/papers/6a44aedf5cd2549c8bc44057 https://doi.org/10.1177/00912174261465528

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July 1, 2026The International Journal of Psychiatry in Medicine

Psychiatric Comorbidity in Heart Failure: Associations With Length of Stay, Costs, and Mortality in a National Cohort

View Full Paper

Ask AI

Bookmark

Key result

Anxiety increases HF hospital stays and costs, while depression is linked to ~14% lower mortality.

OR 0.86
P<0.001
n=31,886,859

Why the study?

To evaluate how specific psychiatric comorbidities relate to index length of stay, hospital costs, and in-hospital mortality during readmissions after heart failure hospitalization.

How do specific psychiatric comorbidities affect length of stay, hospital costs, and mortality in adults hospitalized for heart failure?

Population

31,886,859 weighted HF hospitalizations among adults

Comparison

Specific psychiatric comorbidities vs absence of those comorbidities

Design

Retrospective cohort study

Follow-up

Up to 1 year after discharge

Authors

ACAustin A. Charles KTKyle E Thurmann PEPeter L. Ernst

Discussion

Member takes

Overview

Anxiety was associated with longer heart failure stays; hypothesis-generating for integrated psychiatric care before practice change.

Key Points

This study evaluates how specific psychiatric comorbidities affect length of stay, hospital costs, and mortality rates in heart failure patients.
Retrospective cohort study using 2016-2022 Nationwide Readmissions Database
Included adults with a principal heart failure diagnosis
Used survey-weighted multivariable models to adjust for demographics and comorbidity burden.
Anxiety increased length of stay by 0.88 days (P < 0.001) and costs by $2779 (P < 0.001) without affecting mortality.
Higher mortality odds were associated with lower rates in patients with depression (30-day OR = 0.86), bipolar disorder (0.66), and others (all P < 0.001).
Bipolar disorder associated with the largest cost reduction of $1320 (P < 0.001) compared to patients without it.

Study Design

Type

Cohort (n=31,886,859)

Multicenter

Yes

Structured PICO

How do specific psychiatric comorbidities affect length of stay, hospital costs, and mortality in adults hospitalized for heart failure?

Population

31,886,859 weighted hospitalizations of adults with a principal heart failure diagnosis, evaluated for the impact of psychiatric comorbidities on outcomes up to 1 year after discharge.

Exposure

Presence of specific psychiatric comorbidities (depression, anxiety, bipolar disorder, schizophrenia/psychotic disorders, post-traumatic stress disorder [PTSD], and substance use disorder [SUD])

Comparator

Heart failure patients without the specific psychiatric comorbidity

Outcome

Index length of stay (LOS), inflation-adjusted costs, and in-hospital mortality during readmissions within 30 days and up to 1 year after dischargehard clinical

Main Result

Odds Ratio: 0.86

p-value: p=<0.001

Cite This Study

synapsesocial.com/papers/6a44aedf5cd2549c8bc44057 https://doi.org/10.1177/00912174261465528

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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