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In-hospital mortality and cardiovascular treatment during hospitalization for heart failure among patients with schizophrenia: a nationwide cohort study

Epidemiology and psychiatric sciences, 2023-10, Vol.32, p.e62-e62, Article e62 [Peer Reviewed Journal]

The Author(s), 2023. Published by Cambridge University Press. ;The Author(s), 2023. Published by Cambridge University Press. This work is licensed under the Creative Commons Attribution License This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s) 2023 2023 The Author(s) ;ISSN: 2045-7960 ;EISSN: 2045-7979 ;DOI: 10.1017/S2045796023000744 ;PMID: 37849318

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  • Title:
    In-hospital mortality and cardiovascular treatment during hospitalization for heart failure among patients with schizophrenia: a nationwide cohort study
  • Author: Nishi, Masahiro ; Shikuma, Akira ; Seki, Tomotsugu ; Horiguchi, Go ; Matoba, Satoaki
  • Subjects: Age groups ; Blood pressure ; Body mass index ; cardiovascular disease ; Cohort analysis ; Comorbidity ; Extracorporeal membrane oxygenation ; Heart failure ; Heart rate ; Hospitalization ; Hospitals ; in-hospital mortality ; mental health ; Middle age ; Mortality ; Original ; Original Article ; outcome studies ; Patients ; Psychiatry ; quality of care ; Schizophrenia ; Ventilators
  • Is Part Of: Epidemiology and psychiatric sciences, 2023-10, Vol.32, p.e62-e62, Article e62
  • Description: Abstract Aims Schizophrenia is associated with cardiovascular disease (CVD) risk, and patients with schizophrenia are more likely to receive suboptimal care for CVD. However, there is limited knowledge regarding in-hospital prognosis and quality of care for patients with schizophrenia hospitalized for heart failure (HF). This study sought to elucidate the association between schizophrenia and in-hospital mortality, as well as cardiovascular treatment in patients hospitalized with HF. Methods Using the nationwide cardiovascular registry data in Japan, a total of 704,193 patients hospitalized with HF from 2012 to 2019 were included and stratified by age: young age, > 18 to 45 years ( n  = 20,289); middle age, >45 to 65 years ( n  = 114,947); and old age, >65 to 85 years ( n  = 568,957). All and 30-day in-hospital mortality as well as prescription of cardiovascular medications were assessed. After multiple imputation for missing values, mixed-effect multivariable logistic regression analysis was performed using patient and hospital characteristics with hospital identifier as a variable with random effects. Results Patients with schizophrenia were more likely to experience prolonged hospital stays, and incur higher hospitalization costs. In-hospital mortality for non-elderly patients with schizophrenia was significantly worse than for those without schizophrenia: the mortality rate was 7.6% vs 3.5% and the adjusted odds ratio (OR) was 1.96 (95% confidence interval (CI): 1.24–3.10, P  = 0.0037) in young adult patients; 6.2% vs 4.0% and 1.49 (95% CI: 1.17–1.88, P  < 0.001) in middle-aged patients. Thirty-day in-hospital mortality was significantly worse in middle-aged patients: the mortality rate was 4.7% vs 3.0% and an adjusted OR was 1.40 (95% CI: 1.07–1.83, P  = 0.012). In-hospital mortality in elderly patients did not differ between those with and without schizophrenia. Prescriptions of beta-blockers and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers were significantly lower in patients with schizophrenia across all age groups. Conclusion Schizophrenia was identified as a risk factor for in-hospital mortality and reduced prescription of cardioprotective medications in non-elderly patients hospitalized with HF. These findings highlight the necessity for differentiated care and management of HF in patients with severe mental illnesses.
  • Publisher: Cambridge, UK: Cambridge University Press
  • Language: English;Italian
  • Identifier: ISSN: 2045-7960
    EISSN: 2045-7979
    DOI: 10.1017/S2045796023000744
    PMID: 37849318
  • Source: ProQuest One Psychology
    Open Access: PubMed Central
    Journals@Ovid Open Access Journal Collection Rolling
    DOAJ Directory of Open Access Journals
    AUTh Library subscriptions: ProQuest Central
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