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Increased prevalence of psychosis 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 ,
K. Karnik ,
A. Ganti  and
K. Shah
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, NY, USA
P. Patel
Affiliation:
Windsor University School of Medicine, Public Health, Monee, USA
O. Jayeola
Affiliation:
Drexel University School of Public Health, Public Health, Philadelphia, 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
K. Karnik
Affiliation:
Children's Hospital of San Antonio, Public Health, San Antonio, USA
A. Ganti
Affiliation:
Suburban Medical Center, Internal Medicine, Schaumburg, USA
K. Shah
Affiliation:
Kentucky University, Public Health, Bowling GreenUSA

Abstract

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Objective

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

Background

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

Methods

We used Nationwide Inpatient Sample (NIS) from the healthcare cost and utilization project (HCUP) from year's 2002–2012. We identified AF and psychosis as primary and secondary diagnosis respectively using validated international classification of diseases, 9th revision, and Clinical Modification (ICD-9-CM) codes, and used Cochrane–Armitage trend test and multivariate regression to generate adjusted odds ratios (aOR).

Results

We analyzed total of 3.887.827AF hospital admissions from 2002–2012 of which 1.76% had psychosis. Proportion of hospitalizations with psychosis increased from 5.23% to 14.28% (P trend < 0.001). Utilization of atrial-cardioversion was lower in patients with psychosis (0.76%v vs. 5.79%, P < 0.001). In-hospital mortality was higher in patients with Psychosis (aOR 1.206; 95%CI 1.003–1.449; P < 0.001) and discharge to specialty care was significantly higher (aOR 4.173; 95%CI 3.934–4.427; P < 0.001). The median length of hospitalization (3.13 vs. 2.14 days; P < 0.001) and median cost of hospitalization (16.457 vs. 13.172; P < 0.001) was also higher in hospitalizations with psychosis.

Conclusions

Our study displayed an increasing proportion of patients with Psychosis admitted due to AF with higher mortality and extremely higher morbidity post-AF, and significantly less utilization of atrial-cardioversion. There is a need to explore reasons behind this disparity 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 Viewing: Epidemiology and social psychiatry
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S575 - S576
Copyright
Copyright © European Psychiatric Association 2017
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