Mortality after cardiac or vascular operations by preexisting serious mental illness status in the veterans health administration

Laurel A. Copeland, Edward Y Sako, John E. Zeber, Mary Jo Pugh, Chen-pin Wang, Andrea A. MacCarthy, Marcos Restrepo, Eric M. Mortensen, Valerie A. Lawrence

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: To estimate 1-year mortality risk associated with preoperative serious mental illness (SMI) as defined by the Veterans Health Administration (schizophrenia, bipolar disorder, posttraumatic stress disorder [PTSD], major depression) following nonambulatory cardiac or vascular surgical procedures compared to patients without SMI. Cardiac/vascular operations were selected because patients with SMI are known to be at elevated risk of cardiovascular disease. Method: Retrospective analysis of system-wide data from electronic medical records of patients undergoing nonambulatory surgery (inpatient or day-of-surgery admission) October 2005-September 2009 with 1-year follow-up (N= 55,864; 99% male; < 30 days of postoperative hospitalization). Death was hypothesized to be more common among patients with preoperative SMI. Results: One in nine patients had SMI, mostly PTSD (6%). One-year mortality varied by procedure type and SMI status. Patients had vascular operations (64%; 23% died), coronary artery bypass graft (26%; 10% died) or other cardiac operations (11%; 15%-18% died). Fourteen percent of patients with PTSD died, 20% without SMI and 24% with schizophrenia, with other groups intermediate. In multivariable stratified models, SMI was associated with increased mortality only for patients with bipolar disorder following cardiac operations. Bipolar disorder and PTSD were negatively associated with death following vascular operations. Conclusions: SMI is not consistently associated with postoperative mortality in covariate-adjusted analyses.

Original languageEnglish (US)
Pages (from-to)502-508
Number of pages7
JournalGeneral Hospital Psychiatry
Volume36
Issue number5
DOIs
StatePublished - 2014

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Veterans Health
United States Department of Veterans Affairs
Blood Vessels
Mortality
Post-Traumatic Stress Disorders
Bipolar Disorder
Schizophrenia
Vascular Surgical Procedures
Cardiac Surgical Procedures
Electronic Health Records
Ambulatory Surgical Procedures
Information Systems
Coronary Artery Bypass
Inpatients
Hospitalization
Cardiovascular Diseases
Depression
Transplants

Keywords

  • Cardiovascular surgical procedures
  • Comorbidity
  • Mental disorders
  • Mortality
  • Veterans

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Mortality after cardiac or vascular operations by preexisting serious mental illness status in the veterans health administration. / Copeland, Laurel A.; Sako, Edward Y; Zeber, John E.; Pugh, Mary Jo; Wang, Chen-pin; MacCarthy, Andrea A.; Restrepo, Marcos; Mortensen, Eric M.; Lawrence, Valerie A.

In: General Hospital Psychiatry, Vol. 36, No. 5, 2014, p. 502-508.

Research output: Contribution to journalArticle

Copeland, Laurel A. ; Sako, Edward Y ; Zeber, John E. ; Pugh, Mary Jo ; Wang, Chen-pin ; MacCarthy, Andrea A. ; Restrepo, Marcos ; Mortensen, Eric M. ; Lawrence, Valerie A. / Mortality after cardiac or vascular operations by preexisting serious mental illness status in the veterans health administration. In: General Hospital Psychiatry. 2014 ; Vol. 36, No. 5. pp. 502-508.
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AU - MacCarthy, Andrea A.

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