INCIDENCE AND PREDICTORS OF NEW ONSET SEVERE MENTAL HEALTH ILLNESS AMONGST INPATIENTS READMITTED AFTER A RECENT PULMONARY EMBOLISM: A NATIONAL READMISSION DATABASE ANALYSIS

Document Type

Conference Proceeding

Publication Date

4-1-2025

Publication Title

J Am Coll Cardiol

Keywords

adult, anxiety, chronic thromboembolic pulmonary hypertension, cohort analysis, comorbidity, complication, conference abstract, controlled study, data base, depression, drug therapy, exertional dyspnea, female, health care access, hospital readmission, household income, human, incidence, lowest income group, lung embolism, major clinical study, male, medicare, mental disease, mental health, mental stress, metropolitan area, middle aged, psychosis, retrospective study, schizophrenia, sex difference, social status, socioeconomics

Abstract

Background: Pulmonary embolism (PE) is associated with significant in-hospital mortality and long-term complications, including persistent dyspnea, exercise limitations, and mental stress, collectively known as post-PE syndrome (PPES). While chronic thromboembolic pulmonary hypertension (CTEPH) is well recognized in PPES patients, the psychological effects, particularly severe mental health illness (SMHI), remain underexplored. This study investigates the incidence and predictors of SMHI among patients readmitted after acute PE. Methods A retrospective cohort study was conducted using data from the Nationwide Readmissions Database (NRD) from 2016 to 2020. The NRD, which tracks hospital readmissions across 28 states, was used to identify patients aged 18 or older diagnosed with PE. To focus on new-onset mental health disorders, patients with a documented history of anxiety, depression, or schizophrenia/psychosis were excluded. Readmissions occurring 90+ days post-PE were analyzed for new-onset SMHI. Demographics, comorbidities, and socioeconomic factors were examined as predictors. Results Among readmitted PE patients, women accounted for 61.5% of new-onset anxiety cases (P<0.0001) and 59.2% of new-onset depression cases (P<0.0001). Medicare recipients made up 57.4% of new-onset anxiety (P<0.0001) and 57.4% of new-onset depression (P<0.0001). No significant gender difference was seen for schizophrenia or psychosis. Lower household income was significantly associated with new-onset schizophrenia, with 42.3% of cases (P<0.0001) in the lowest income quartile; this effect was not seen for anxiety or depression. Non-metropolitan areas reported the lowest incidence of all conditions, indicating potential urban-rural disparities. Conclusion The associations with gender, socioeconomic status, and insurance highlight the need for targeted mental health interventions, especially for women, Medicare recipients, and low-income patients. Urban-rural disparities suggest that geographical factors may affect access to care, supporting region-specific approaches. Early identification of at-risk patients could improve outcomes and reduce healthcare burdens.

Volume

85

Issue

12

First Page

2172

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