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Increased Prevalence of Major Depressive Disorder in Patients who Get Admitted with Atrial Fibrillation with Worse Outcomes

Published online by Cambridge University Press:  23 March 2020

Z. Mansuri ,
S. Patel ,
P. Patel ,
O. Jayeola ,
A. Das ,
J. Shah ,
M.H. Gul ,
A. Ganti ,
K. Karnik  and
R. Patel
Z. Mansuri
Affiliation:
Texas Tech University Health Sciences Center Permian Basin Campus, Psychiatry, Odessa, USA
S. Patel
Affiliation:
Icahn School of Medicine at Mount Sinai, Public Health, New York, USA
P. Patel
Affiliation:
Windsor University School of Medicine, Public Health, Monee, USA
O. Jayeola
Affiliation:
Drexel University School of Public Health, Public Health, Philadephia, USA
A. Das
Affiliation:
Florida Hospital, Internal Medicine, Orlando, USA
J. Shah
Affiliation:
Pramukhswami Medical College, Internal Medicine, Karamsad, India
M.H. Gul
Affiliation:
St. Louis University Hospital, Nephrology, St. Louis, USA
A. Ganti
Affiliation:
Suburban Medical Center, Internal Medicine, Schaumburg, USA
K. Karnik
Affiliation:
Children's Hospital of San Antonio, Public Health, San Antonio, USA
R. Patel
Affiliation:
Acardia University, Public Health, Glenside, USA

Abstract

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Objective

To determine trends and impact on outcomes of atrial fibrillation (AF) in patients with pre-existing major depressive disorder(MDD).

Background

While post-AF MDD has been extensively studied, contemporary studies including temporal trends on impact of pre-AF MDD on AF and post-AF outcomes are lacking.

Methods

We used Nationwide Inpatient Sample (NIS) from Healthcare Cost and Utilization Project (HCUP) from 2002 to 2012. We identified AF and MDD as primary and secondary diagnosis respectively using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD9CM) codes, and used Cochrane-Armitage trend test and multivariate regression to generate adjusted odds ratios (aOR).

Results

We analyzed total of 3,887,827 AF hospital admissions from 2002 to 2012 of which 6.78% had MDD. Proportion of hospitalizations with MDD increased from 4.93% to 14.19% (P-trend < 0.001). Utilization of atrial cardioversion was lower in patients with MDD (34.37% vs. 40.52%, P < 0.001). In-hospital mortality was significantly lower in patients with MDD (aOR0.749; 95% CI 0.664–0.846; P < 0.001) but discharge to specialty care was higher (aOR 1.695; 95%CI 1.650–1.741; P < 0.001). In addition, median length of hospitalization (2.5 vs. 2.13 days; P < 0.001) and median cost of hospitalization (28,246 vs. 22,663; P < 0.001) was higher in hospitalizations with MDD.

Conclusions

Our study displayed an increasing proportion of patients with MDD admitted due to AF in the last decade with lower mortality but higher morbidity post-AF. In addition, there was significantly less utilization of atrial cardioversion in this population along with higher median length and cost of hospitalization. There is a need to explore the reasons behind this disparity in outcomes and atrial cardioversion utilization in order to improve post-AF outcomes in this vulnerable population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Walk: Epidemiology and social psychiatry
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. s246 - s247
Copyright
Copyright © European Psychiatric Association 2017
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