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Adverse hospital events for mentally ill patients undergoing coronary artery bypass surgery

Yue Li1, Laurent G Glance, Xueya Cai

  • 1Department of Medicine, ECMC, Clinical Center CC-163, State University of New York at Buffalo, 462 Grider Street, Buffalo, NY 14215, USA. yueli@buffalo.edu

Health Services Research
|July 31, 2008
PubMed

Insights

Patients with mental disorders undergoing coronary artery bypass graft (CABG) surgery face higher risks of anesthesia complications, decubitus ulcers, and hip fractures. These findings highlight the need for targeted care strategies in cardiac surgery for mentally ill patients.

Area of Science:

  • Cardiovascular Surgery
  • Psychiatric Comorbidities
  • Patient Safety

Background:

  • Patients with mental disorders have a higher burden of coronary heart disease.
  • Individuals with mental illness may encounter unique safety challenges during inpatient cardiac care.
  • Coronary artery bypass graft (CABG) surgery is a critical intervention for severe coronary heart disease.

Purpose of the Study:

  • To investigate and compare the postoperative complication rates in patients with and without mental disorders who underwent isolated CABG surgery.
  • To identify specific complications associated with mental disorders in the context of CABG procedures.

Main Methods:

  • Retrospective analysis of New York state hospital claims data from 1997 to 2004.
  • Inclusion of a large cohort of 135,701 patients undergoing isolated CABG surgery.
  • Definition and measurement of complications using the Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ PSI).

Main Results:

  • Mental disorders were significantly associated with increased anesthesia complications (AOR=6.44, p < .001).
  • Higher rates of decubitus ulcer (AOR=1.42, p = .006) and postoperative hip fracture (AOR = 3.29, p < .001) were observed in patients with mental disorders.
  • An overall higher complication rate across nine PSIs was linked to mental disorders (AOR = 1.27, p < .001).

Conclusions:

  • Patients with mental illness undergoing CABG surgery exhibit a greater likelihood of experiencing potentially preventable complications and iatrogenic injuries.
  • The findings underscore the vulnerability of mentally ill patients during major cardiac surgery.
  • Further research is required to elucidate the underlying mechanisms contributing to these increased complication rates.
Abstract

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