在心肌梗塞后的精神疾病和心血管程序的使用
B G Druss1, D W Bradford, R A Rosenheck
1Department of Psychiatry, Yale University School of Medicine, VA Northeast Program Evaluation Center, New Haven, Conn, USA. benjamin.druss@yale.edu
JAMA
|February 5, 2000
概括
患有精神疾病的患者在急性心肌梗塞后接受心脏导管治疗,皮肤透光冠状动脉血管塑造 (PTCA) 或冠状动脉旁路移植 (CABG) 的可能性显著降低.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 现有的研究表明,在心血管手术率上存在种族和性别差异.
- 伴随性精神障碍可能与由于临床,社会经济,患者和提供者因素的心血管手术率降低有关.
研究的目的:
- 为了确定患有并发性精神障碍的患者是否在急性心肌梗塞后不太可能接受心脏导管或再血管.
主要方法:
- 一项回顾性队列研究分析了来自医疗病历和行政档案的数据.
- 这项研究包括了113,653名65岁以上的患者,他们在1994年2月至1995年7月期间因急性心肌梗塞住院治疗.
- 伴随性精神障碍包括精神分裂症,主要情绪障碍,药物滥用/依赖以及其他精神障碍.
主要成果:
- 患有任何精神障碍的患者经受皮肤透光冠状动脉血管塑造 (PTCA) 或冠状动脉旁路移植 (CABG) 的可能性明显低.
- 在对共变量进行调整后,与没有心脏导管相比,患有精神障碍的人患心脏导管的可能性为41-78%.
- 在患有精神障碍和没有精神障碍的患者之间没有观察到30天死亡率的显著差异.
结论:
- 伴随性精神障碍与冠状动脉复血管化手术的发生率相对较低有关.
- 需要进行进一步的研究,以探索导致这些差异的患者和提供者因素及其对护理质量和结果的影响.
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