Prior psychiatric hospitalization is associated with excess mortality in patients hospitalized with non-cardiac chest pain: a data linkage study based on the full Scottish population (1991–2006)

European Heart JournalGillies M et al. | December 05, 2011

Non–cardiac chest pain is not an entirely benign condition. Individuals with a hospital discharge diagnosis of NCCP who have a previous psychiatric hospitalization have a greater risk of death, all–cause, and CVD–specific, at 1 year, than those without. A NCCP hospitalization is an opportunity to engage, and where appropriate, intervene to modify cardiovascular risk in this difficult–to–reach and high–risk group.

Methods

  • This was a population–based retrospective cohort study of 159 888 patients discharged from hospital in Scotland (1991–2006) following a first NCCP hospitalization, using routinely collected morbidity and mortality data.
  • All–cause and cardiovascular disease (CVD) mortality at 1 year following hospitalization was examined.
  • A total of 3514 (4.4%) men and 3136 (3.9%) women with a first NCCP hospitalization had a psychiatric hospitalization in the 10 years preceding incident NCCP hospitalization.
  • Those with a previous psychiatric hospitalization were younger and more socioeconomically deprived (SED).
  • Overall, crude case fatality at 1 year was 4.4% in men and 3.7% in women.

Results

  • This was higher in patients with a previous psychiatric hospitalization compared with those without (overall: men 6.3 vs. 4.3%; women: 5.3 vs. 3.6%), in all age groups and all SED quintiles.
  • Following adjustment (year of NCCP hospitalization, SED, co–morbid diabetes, and hypertension), the hazard of all–cause and CVD–specific death at 1 year was higher in men and women with a previous psychiatric hospitalization than without, with effect modification according to age group.

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