Abstract TP381: Stroke Morbidity And Mortality In Patients With A History Of Psychosis-an Observational Study Of 158478 Stroke Cases In The National Swedish Riks-Stroke Cohort
Background and purpose: Patients with a psychosis (P) have a much higher risk of cardiovascular ischemic morbidity and mortality as compared to the general population without psychosis (NP). The aim of this prospective observational study was to investigate associations between hemorrhagic and/or ischemic stroke and 90 days mortality in patients with different types of psychoses.
Methods: Data on stroke, psychoses and diagnoses of co-morbidity (atrial fibrillation, hypertension, diabetes, ischemic heart disease) were collected from the national in patient registry. All adult stroke patients registered in 2001-10 in the Swedish Stroke Register were identified. Incidence of stroke, and all-cause mortality for PP and NP as well as subgroups with schizophrenia, bipolar disease and other psychoses were calculated. Crude and adjusted (sex, age, consciousness, co-morbidities) OR and 95% confidence intervals (CIs) were estimated in a logistic regression model.
Results: PP had a 1.19 (CI: 1.153-1.2176) higher risk of having a stroke as compared to NP. Out of 158478 cases of stroke, 6796 (total 4.3%), PP 759 (0.5%) had schizophrenia, 566 (0.4%) bipolar, and 5503 (3.5%) other psychoses. No statistical difference in type of stroke was seen between PP (12.7%) and NP (12.6%). Among NP 24617 (16.2%) died within 90 days as compared to 18.9% in PP and in the adjusted model the OR of death was 1.11 (CI 1.027-1.194) for PP vs NP. Corresponding ORs for schizophrenia was 1.76 (CI 1.402-2.214), bipolar disease 1.32 (CI 1.011-1.717) and 1.04 (CI 0.952-1.124) for other psychoses.
Conclusions: Patients with a history of psychoses have a higher risk of death within 90 days of a stroke and patients with schizophrenia were found to have the highest risk of all.
- © 2012 by American Heart Association, Inc.