Abstract 12291: Impact of History of Mental Health Disorder on In-Hospital Mortality in Patients With Heart Failure. A Population-Based Cohort Study

Abstract

Introduction: Mental health disorders are associated with lower life expectancy and patients with mental disorders are at an increased risk of heart failure. Data on the prognostic impact of mental disorders on heart failure outcomes is limited and inconclusive. Hypothesis: Mental health disorders are associated with increased risk of in-hospital mortality in patients with heart failure. Methods: The study population were patients aged ≥18 years in acute care hospitals with heart failure as principal diagnosis in Texas for years 2016 through 2021. Three prespecified models were applied to estimate the association between mental disorders and in-hospital mortality. Multilevel, multivariable logistic regression with propensity adjustment was the primary analysis approach with propensity score matching and multivariable logistic regression without propensity adjustment applied as alternative analyses. Additional analyses were completed for patient subgroups, categories of mental disorders, and classifications of heart failures. Results: Out of 513,565 heart failure hospitalizations, 103,675 (20.2%) had mental disorders. Heart failure hospitalizations with vs without mental disorders were more commonly female (61.3% vs 46.0%), white (55.3% vs 46.9%), and obese (31.6% vs 26.4%), but had less frequent need for mechanical ventilation (1.8% vs 2.1%); p < 0.0001 for each. Unadjusted in-hospital mortality among heart failure hospitalizations with and without mental disorders was 1.7% vs 2.2%. On adjusted analyses, mental disorders remained associated with lower odds of in-hospital mortality (adjusted odds ratio 0.8650 [95% CI 0.8149-0.9183]). The results were similar for the alternative modeling approaches, subgroup analyses, and classifications of heart failure. Conclusion: Mental disorders were associated with substantially lower risk of in-hospital mortality for patients with a principal diagnosis of heart failure.