Abstract 14807: Effect of Psychiatric Illnesses on the Stress Induced Cardiomyopathy Readmission

Abstract

Introduction: Stress-induced cardiomyopathy (SIC) is a form of transient non-ischemic cardiomyopathy that is precipitated in the setting of acute emotional or physical stress. Postulated hypothesis implicated catecholaminergic excess and a role of the brain-heart axis behind its pathogenesis. The impact of different psychiatric illnesses on the outcomes of SIC is not clear. Method: We conducted a retrospective study using National Readmission Database (NRD) from 2011 to 2019 using ICD-10-CM (International Classification of Diseases, 10th Edition, Clinical Modification) and ICD-9-CM codes to identify the admissions with the discharge diagnosis of SIC and stratified them based on the presence of psychiatric illnesses. The primary outcome was six-month readmission and predictors of readmission. Result: We included a total of 98,721 admissions with a diagnosis of SIC. Among them, 12.9% had major depression, 1.8% had bipolar disorder, 17.6% had an anxiety disorder, and 0.6% had schizophrenia. Overall, patients with psychiatric illnesses were younger. Patients with psychiatric illnesses had a higher burden of comorbidities. Patients with schizophrenia had higher in-hospital mortality. Patients with psychiatric illnesses had a higher likelihood of getting readmitted within six months (p<0.001). The significant independent positive predictors of readmission within 6 months were history of diabetes [odds ratio (OR):1.21, confidence interval (CI):1.16-1.26], heart failure (OR:1.31, CI:1.26-1.36), CKD/ESRD (OR: 1.44, CI:1.37-1.51), AF (OR: 1.25, CI:1.20-1.31), anemia (OR:1.24, CI: 1.15-1.34), peripheral arterial disease (OR: 1.25, CI:1.18-1.33), chronic obstructive pulmonary disease (OR: 1.35, CI:1.29-1.40), and prior stroke (OR: 1.10, CI: 1.02-1.18). Conclusion: We witnessed that psychiatric illnesses were associated with a higher likelihood of six-month readmission in patients with SIC.