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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)

Title: 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)
Authors: Gillies, Michelle; Jhund, Pardeep S.; MacTeague, Karen; MacIntyre, Paul; Allardyce, Judith; Batty, G. David; MacIntyre, Kate
Publisher Information: Oxford University Press
Publication Year: 2012
Collection: HighWire Press (Stanford University)
Subject Terms: Prevention and epidemiology
Description: 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.
Document Type: text
File Description: text/html
Language: English
Relation: http://eurheartj.oxfordjournals.org/cgi/content/short/33/6/760; http://dx.doi.org/10.1093/eurheartj/ehr401
DOI: 10.1093/eurheartj/ehr401
Availability: http://eurheartj.oxfordjournals.org/cgi/content/short/33/6/760; https://doi.org/10.1093/eurheartj/ehr401
Rights: Copyright (C) 2012, European Society of Cardiology
Accession Number: edsbas.AEE8F1CD
Database: BASE