Tags

Type your tag names separated by a space and hit enter

Acute exacerbations of chronic obstructive pulmonary disease and the effect of existing psychiatric comorbidity on subsequent mortality.
Psychosomatics 2011 Sep-Oct; 52(5):441-9P

Abstract

OBJECTIVES

Studies investigating associations between chronic obstructive pulmonary disease (COPD) outcomes and psychiatric comorbidity have yielded mixed findings. We examined a national sample of hospitalized COPD patients to evaluate the impact of three psychiatric conditions on mortality and readmission.

METHODS

Department of Veterans Affairs (VA) administrative and laboratory data were used to identify 26,591 consecutive patients admitted for COPD during October 2006 to September 2008. Associations between psychiatric comorbidity and both 30-day mortality and readmission were examined using generalized estimating equations and Cox proportional hazards regression, respectively, with adjustments for patient demographics, medical comorbidities, illness severity, and clustering within hospitals.

RESULTS

Unadjusted 30-day mortality was higher in patients with anxiety (5.3% vs. 3.8% [P < 0.001]) and depression (6.2% vs. 3.8% [<0.001]). In multivariable analyses, adjusted odds of 30-day mortality were higher for patients with depression (OR, 1.53; 95% CI, 1.28-1.82) and anxiety (OR, 1.72; 1.42 -2.10), but not for patients with PTSD (OR, 1.19; 0.92-1.55). Unadjusted 30-day readmission rates also varied by diagnosis; depression and PTSD were associated with lower rates of readmission (10.4% vs. 11.6% [<0.05] and 8.6% vs. 11.6% [<0.001], respectively), whereas anxiety was not (11.3% vs. 11.5% [NS]). However, after covariate adjustment using multivariable models, anxiety and depression (but not PTSD) were associated with increased risk for readmission (HR, 1.22; 1.03 -1.43 and HR, 1.35; 1.18 -1.54, respectively).

CONCLUSION

Comorbid anxiety and depression may have an adverse impact on COPD hospital prognosis or may be indicative of more severe illness.

Authors+Show Affiliations

VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region, Iowa City VAMC, Iowa City, IA, USA. thad-abrams@uiowa.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

21907063

Citation

Abrams, Thad E., et al. "Acute Exacerbations of Chronic Obstructive Pulmonary Disease and the Effect of Existing Psychiatric Comorbidity On Subsequent Mortality." Psychosomatics, vol. 52, no. 5, 2011, pp. 441-9.
Abrams TE, Vaughan-Sarrazin M, Van der Weg MW. Acute exacerbations of chronic obstructive pulmonary disease and the effect of existing psychiatric comorbidity on subsequent mortality. Psychosomatics. 2011;52(5):441-9.
Abrams, T. E., Vaughan-Sarrazin, M., & Van der Weg, M. W. (2011). Acute exacerbations of chronic obstructive pulmonary disease and the effect of existing psychiatric comorbidity on subsequent mortality. Psychosomatics, 52(5), pp. 441-9. doi:10.1016/j.psym.2011.03.005.
Abrams TE, Vaughan-Sarrazin M, Van der Weg MW. Acute Exacerbations of Chronic Obstructive Pulmonary Disease and the Effect of Existing Psychiatric Comorbidity On Subsequent Mortality. Psychosomatics. 2011;52(5):441-9. PubMed PMID: 21907063.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute exacerbations of chronic obstructive pulmonary disease and the effect of existing psychiatric comorbidity on subsequent mortality. AU - Abrams,Thad E, AU - Vaughan-Sarrazin,Mary, AU - Van der Weg,Mark W, PY - 2011/01/13/received PY - 2011/03/16/revised PY - 2011/03/17/accepted PY - 2011/9/13/entrez PY - 2011/9/13/pubmed PY - 2012/1/27/medline SP - 441 EP - 9 JF - Psychosomatics JO - Psychosomatics VL - 52 IS - 5 N2 - OBJECTIVES: Studies investigating associations between chronic obstructive pulmonary disease (COPD) outcomes and psychiatric comorbidity have yielded mixed findings. We examined a national sample of hospitalized COPD patients to evaluate the impact of three psychiatric conditions on mortality and readmission. METHODS: Department of Veterans Affairs (VA) administrative and laboratory data were used to identify 26,591 consecutive patients admitted for COPD during October 2006 to September 2008. Associations between psychiatric comorbidity and both 30-day mortality and readmission were examined using generalized estimating equations and Cox proportional hazards regression, respectively, with adjustments for patient demographics, medical comorbidities, illness severity, and clustering within hospitals. RESULTS: Unadjusted 30-day mortality was higher in patients with anxiety (5.3% vs. 3.8% [P < 0.001]) and depression (6.2% vs. 3.8% [<0.001]). In multivariable analyses, adjusted odds of 30-day mortality were higher for patients with depression (OR, 1.53; 95% CI, 1.28-1.82) and anxiety (OR, 1.72; 1.42 -2.10), but not for patients with PTSD (OR, 1.19; 0.92-1.55). Unadjusted 30-day readmission rates also varied by diagnosis; depression and PTSD were associated with lower rates of readmission (10.4% vs. 11.6% [<0.05] and 8.6% vs. 11.6% [<0.001], respectively), whereas anxiety was not (11.3% vs. 11.5% [NS]). However, after covariate adjustment using multivariable models, anxiety and depression (but not PTSD) were associated with increased risk for readmission (HR, 1.22; 1.03 -1.43 and HR, 1.35; 1.18 -1.54, respectively). CONCLUSION: Comorbid anxiety and depression may have an adverse impact on COPD hospital prognosis or may be indicative of more severe illness. SN - 1545-7206 UR - https://www.unboundmedicine.com/medline/citation/21907063/Acute_exacerbations_of_chronic_obstructive_pulmonary_disease_and_the_effect_of_existing_psychiatric_comorbidity_on_subsequent_mortality_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0033-3182(11)00170-8 DB - PRIME DP - Unbound Medicine ER -