NEW YORK, Jan 25 (Reuters Health) -- Patients with mental illness are less
likely to undergo procedures that reestablish blood flow after a heart attack,
such as angioplasty, cardiac catheterization or bypass surgery, US researchers
report.
Dr. Benjamin G. Druss from Yale University School of Medicine in New
Haven, Connecticut, and colleagues reviewed data from 113,653 patients in the
United States aged 65 and older who had been hospitalized for a heart attack
between 1994 and 1995. Their findings are published in the January 26th issue of
The Journal of the American Medical Association.
The investigators found that 5,365 of these patients had also been
diagnosed with a mental disorder. And this group of patients were significantly
less likely to undergo cardiac revascularization procedures -- those that
restore blood flow to the heart muscle after a heart attack, the researchers
report.
But the team also found that despite this difference, the death rate after
30 days was similar in patients with and without mental disorders.
Druss and colleagues note that the differences in the likelihood of
receiving additional treatment could be largely explained by differences in
rates of referral, that is, fewer heart attack patients with mental disorders
were sent for cardiac catheterization. Although all patients were covered by
Medicare and the analyses had adjusted for other factors, the authors also note
that patients with mental disorders tended to receive treatment at hospitals
where cardiac revascularization procedures were not available.
"Further research is needed to understand the degree to which patient and
provider factors contribute to this difference and its implications for quality
and long-term outcomes of care," the authors conclude.
