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Outcomes of comorbid mental health disorders in cardiovascular surgery

Grace M Soltesz1,2, Jose L Diz Ferre1,3, Guangjin Zhou3

  • 1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA.

Journal of Thoracic Disease
|June 17, 2026
PubMed

Insights

Patients with mental health disorders (MHDs) had lower in-hospital mortality but longer stays after cardiovascular surgery. MHDs were linked to increased complications and readmissions, highlighting the need for integrated mental health care.

Area of Science:

  • Cardiovascular Surgery
  • Public Health
  • Mental Health Research

Background:

  • Mental illness is a significant global public health issue.
  • Traditional cardiac surgery risk tools lack mental health disorder assessment.
  • Pre-existing mental health disorders (MHDs) impact cardiovascular surgery outcomes.

Purpose of the Study:

  • To investigate the effect of pre-existing mental health disorders (MHDs) on cardiovascular surgery outcomes.
  • To analyze the association between MHDs and in-hospital mortality, complications, and readmissions.
  • To inform risk stratification and patient management in cardiac surgery.

Main Methods:

  • Utilized the 2016-2018 Nationwide Readmissions Database (NRD).
  • Identified cardiovascular surgery patients with and without MHDs using relevant codes.
  • Employed propensity score matching (PSM) and multivariable logistic regression for analysis.

Main Results:

  • 20% of 844,830 cardiovascular surgery patients had MHDs.
  • MHDs associated with lower in-hospital mortality (2.3% vs. 3.2%) but longer length of stay (12 vs. 11 days).
  • MHDs increased odds of complications (aOR: 1.16) and 30/90-day readmissions (aOR: 1.17/1.18).

Conclusions:

  • Mental health disorders are prevalent in cardiovascular surgery patients.
  • While in-hospital mortality was lower, MHDs correlate with increased complications and readmissions.
  • Optimizing psychiatric status and mental health professional involvement may improve outcomes.
Abstract

Keywords:
Cardiovascular surgerymental health disorders (MHDs)nationwide outcomes

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