New Chest Pain Study Findings Reported from University of Washington (Disparities In Cardiovascular Outcomes Among Emergency Department Patients With Mental Illness): Chest Pain

2022 AUG 30 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Fresh data on Chest Pain are presented in a new report. According to news reporting originating in Seattle, Washington, by NewsRx journalists, research stated, “Patients with mental illness have been shown to receive lower quality of care and experience worse cardiovascular (CV) outcomes compared to those without mental illness. This present study examined mental health-related disparities in CV outcomes after an Emergency Department (ED) visit for chest pain.”

Financial support for this research came from NIH National Institute of Mental Health (NIMH).

The news reporters obtained a quote from the research from the University of Washington, “This retrospective cohort included adult Medicaid beneficiaries in Washington state discharged from the ED with a primary diagnosis of unspecified chest pain in 2010-2017. Outcomes for patients with any mental illness (any mental health diagnosis or mental-health specific service use within 1 year of an index ED visit) and serious mental illness (at least two claims (on different dates of service) within 1 year of an index ED visit with a diagnosis of schizophrenia, other psychotic disorder, or major mood disorder) were compared to those of patients without mental illness. Our outcomes of interest were the incidence of major adverse cardiac events (MACE) within 30 days and 6 months of discharge of their ED visit, defined as a composite of death, acute myocardial infarction (AMI), CV rehospitalization, or revascularization. Secondary outcomes included cardiovascular diagnostic testing (diagnostic angiography, stress testing, echocardiography, and coronary computed tomography (CT) angiography) rates within 30 days of ED discharge. Only treat-and-release visits were included for outcomes assessment. Hierarchical logistic random effects regression models assessed the association between mental illness and the outcomes of interest, controlling for age, gender, race, ethnicity, Elixhauser comorbidities, and health care use in the past year, as well as fixed year effects. There were 98,812 treat-and-release ED visits in our dataset. At 30 days, enrollees with any mental illness had no differences in rates of MACE (AOR 0.96; 95% CI, 0.72-1.27) or any of the individual components. At 6 months, enrollees with any mental illness (AOR 1.86; 95% CI, 1.11-3.09) and serious mental illness (AOR 2.60; 95% CI 1.33-5.13) were significantly more likely to be hospitalized for a CV condition compared to those without mental illness. Individuals with any mental illness had higher rates of testing at 30 days (AOR 1.16; 95% CI 1.07-1.27).”

According to the news reporters, the research concluded: “Patients with mental illness have similar rates of MACE, but higher rates of certain CV outcomes, such as CV hospitalization and diagnostic testing, after an ED visit for chest pain.”

This research has been peer-reviewed.

For more information on this research see: Disparities In Cardiovascular Outcomes Among Emergency Department Patients With Mental Illness. The American Journal of Emergency Medicine, 2022;55:51-56. The American Journal of Emergency Medicine can be contacted at: W B Saunders Co-elsevier Inc, 1600 John F Kennedy Boulevard, Ste 1800, Philadelphia, PA 19103-2899, USA.

Our news correspondents report that additional information may be obtained by contacting Shilpa Kumar, University of Washington, School of Medicine, Seattle, WA, United States. Additional authors for this research include Herbert C. Duber, Amber K. Sabbatini and William Kreuter.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.ajem.2022.02.037. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

(Our reports deliver fact-based news of research and discoveries from around the world.)