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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)

Citation

Gillies, M and Jhund, PS and MacTeague, K and MacIntyre, P and Allardyce, J and Batty, GD and Macintyre, K, 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 Journal, 33, (6) pp. 760-767. ISSN 0195-668X (2012) [Refereed Article]

DOI: doi:10.1093/eurheartj/ehr401

Abstract

AIMS: Non-cardiac chest pain (NCCP) is considered a benign condition. We investigate case-fatality following an incident hospitalization for NCCP and determine whether previous psychiatric hospitalization is associated with short-term mortality.

METHODS AND RESULTS: 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. 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.

CONCLUSION: 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.

Item Details

Item Type:Refereed Article
Keywords:Mortality; Non-cardiac chest pain; Predictors; Psychiatric disorder
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Macintyre, K (Dr Kate Macintyre)
ID Code:95673
Year Published:2012
Web of Science® Times Cited:3
Deposited By:Medicine (Discipline)
Deposited On:2014-10-07
Last Modified:2017-11-03
Downloads:0

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