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Nonpsychiatric hospitalization rates poststroke similar between patients with and without SMI

23 Aug 2017

There is no significant difference in the adjusted rate of nonpsychiatric hospitalization between stroke patients with and without severe mental illness (SMI), a new study has shown.

“However, unadjusted results continue to draw attention to disparities, with SMI patients experiencing more nonpsychiatric hospitalizations both prior to and up to one year after their initial stroke,” wrote researchers.

In the study cohort of 523 index stroke patients, SMI comorbidity was present in 100 and absent in the remaining 423. Those with SMI were more likely to be younger (p<0.0001), unwed (p=0.0107) and have a history of depression, substance abuse and post-traumatic stress disorder (PTSD; p<0.0001 for all).

Patients with SMI had significantly higher rates of mean prestroke nonpsychiatric hospitalizations compared with their non-SMI counterparts (1.47±0.51 vs 1.00±1.33; p=0.0004). However, while mean hospitalization was significantly higher in SMI patients during the first year, rates were comparable between the two groups at all time points after the first year.

In the fourth year after stroke, nonpsychiatric hospitalization rates were significantly lower in SMI patients.

After adjustments for covariates such as PTSD and history of depression, the risk of nonpsychiatric hospitalizations did not differ significantly between SMI and non-SMI patients across all time points after stroke.

The retrospective cohort study included 523 veterans who were treated for initial stroke. Relevant demographic, comorbidity, clinical and follow-up data were obtained from administrative records. Multivariate Poisson regression was used to determine the association between SMI and nonpsychiatric hospitalization after stroke.

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