학술논문

Outcome of patients with acute symptomatic pulmonary embolism and psychiatric disorders.
Document Type
Article
Source
Thrombosis Research. Sep2020, Vol. 193, p90-97. 8p.
Subject
*MENTAL illness
*HYPERCOAGULATION disorders
*PULMONARY embolism
*LOGISTIC regression analysis
*ODDS ratio
*SENSITIVITY analysis
Language
ISSN
0049-3848
Abstract
To address the association between psychiatric disorders and short-term outcomes after acute symptomatic pulmonary embolism (PE). We identified adults with PE enrolled in the RIETE registry between December 1, 2013, and January 31, 2019. Using multinomial regression, we assessed the association between a history of psychiatric disorders and the outcomes of all-cause mortality, PE-related mortality, and venous thromboembolism recurrence and bleeding rates through 30 days after initiation of treatment. We also examined the impact of depression on all-cause and PE-specific mortality. Among 13,120 patients diagnosed with acute PE, 16.1% (2115) had psychiatric disorders and 4.2% died within the first 30-days of follow-up. Patients with psychiatric disorders had increased odds for all-cause (adjusted odds ratio [ OR ] 1.50; 95% CI, 1.21 to 1.86; P < 0.001) and PE-related mortality (adjusted OR 1.64; 95% CI, 1.09 to 2.48; P = 0.02) compared to those without psychiatric disorders. Multinomial logistic regression showed a non-significant trend toward lower risk of recurrences for patients with psychiatric disorders (adjusted OR 0.49; 95% CI, 0.21 to 1.15; P = 0.10). Psychiatric disorders were not significantly associated with increased odds for major bleeds during follow-up (adjusted OR 1.09; 95% CI, 0.85 to 1.40; P = 0.49). Results were consistent in a sensitivity analysis that only considered patients with a diagnosis of depression. In patients with acute PE, history of psychiatric disorders might predict all-cause and PE-related death in the ensuing month after diagnosis. • If psychiatric disorders are associated with prognosis after PE, interventions might be worth testing to mitigate outcomes. • In patients with PE, history of psychiatric disorders is a predictor of death in the ensuing month after diagnosis. • Depression was associated with a 1.4-fold increase in the odds of 30-day all-cause mortality. [ABSTRACT FROM AUTHOR]