Vascular surgery receipt and outcomes for people with serious mental illnesses: Retrospective cohort study using a large mental healthcare database in South London
| Autor: | Sajini Kuruppu, Marvey Ghani, Robert Stewart, Ruwan Alwis Weerakkody, Matthew Harris, Megan Pritchard, Gayan Perera |
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| Rok vydání: | 2020 |
| Předmět: |
Mental Health Services
medicine.medical_specialty Bipolar Disorder Population Schizoaffective disorder 03 medical and health sciences 0302 clinical medicine London medicine Humans 030212 general & internal medicine Bipolar disorder education Retrospective Studies education.field_of_study business.industry Mental Disorders Retrospective cohort study Odds ratio Vascular surgery medicine.disease Mental illness Mental health Psychiatry and Mental health Clinical Psychology Emergency medicine business 030217 neurology & neurosurgery |
| Zdroj: | Journal of psychosomatic research. 147 |
| ISSN: | 1879-1360 |
| Popis: | Objective Vascular surgery can be common among people with serious mental illness (SMI) given the high prevalence of cardiovascular disease. However, post-operative outcomes following vascular surgery have received little investigation, particularly in a subpopulation of SMI. Methods We conducted a retrospective observational study using data from the South London and Maudsley NHS Foundation Trust (SLaM) via its Clinical Record Interactive Search (CRIS) platform and linkage with Hospital Episode Statistic (HES). Vascular surgery recipients were identified using OPCS version 4 codes. Length of stay (LOS) was modelled using Incidence Rate Ratios (IRRs), and 30-day emergency hospital readmissions using Odds Ratios (ORs) for people with SMI compared with the general population. Results Vascular surgery was received by 152 patients with SMI diagnoses (schizophrenia, schizoaffective disorder, bipolar disorder) and 8821 catchment residents without any mental health conditions. People with active SMI symptoms more likely to be admitted to hospital via emergency route OR: 1.80 (95% CI: 1.06, 3.07) and more likely to stay longer in the hospital for vascular surgery IRR: 1.35 (1.01, 1.80) and more likely to be readmitted to hospital via emergency route within 30 days OR: 1.53 (1.02, 2.67). People with SMI who had major open vascular surgery and peripheral endovascular surgery more likely to have worse post-operative outcomes. Conclusion Our study highlights the risks faced by people with SMI following vascular surgery. These suggest tailored guidelines and policies are needed, based on the identification of pre-operative risk factors, allowing for focused post-vascular surgery care to minimise adverse outcomes. |
| Databáze: | OpenAIRE |
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