Nationwide Trends in Cardiovascular and Cerebrovascular Diseases and Outcomes Among Young Adults (18-39 years) Hospitalized With Comorbid Depression.

Rupak Desai,Zeeshan Mansuri,Hee Kong Fong,Yash Varma,Rajkumar Doshi,Vijaya Lakhsmi Valaparla,Zainab Gandhi,Virmitra Desai,Kaksha Varma,Mir Z Ali Khan,Bashar Dawood,Sejal Savani

doi:10.7759/cureus.10640

Abstract

BackgroundModern-day studies that assess temporal trends in cardiovascular and cerebrovascular events (CCE) and outcomes among the young population in the United States (US) with depression remain limited.MethodsWe compared baseline demographics, comorbidities, all-cause mortality, acute myocardial infarction (AMI), percutaneous coronary interventions (PCI), arrhythmia, stroke, and venous thromboembolism (VTE) among hospitalized young adults (18-39 years) with vs. without depression using the National Inpatient Sample (NIS) from 2007 to 2014.ResultsA total of 3,575,275 patients out of 63,020,008 hospitalized young adults had comorbid depression (5.7%; median 31 years, 71.3% females). The depressed cohort more often comprised of older, white, male, and non-electively admitted patients. Higher rates of comorbidities, all-cause mortality, PCI, arrhythmia, VTE, and stroke were observed among the depressed cohort. The rising trend in all-cause mortality was observed among the depressed against a stable trend in the non-depressed. The prevalence of AMI remained stable among depressed with consistent upsurges in arrhythmia and stroke. Those with depression had extended hospital stay, higher hospitalization charges, and were more often transferred to other facilities or discharged against advice.ConclusionsRising trends of inpatient mortality, CCE, and higher resource utilization among young adults with depression are concerning and warrants a multidisciplinary approach to improve quality of life and outcomes.

Highlights

Depression and cardiovascular disease (CVD) are known to be the leading causes of disability worldwide [1]
All-cause mortality, percutaneous coronary interventions (PCI), arrhythmia, venous thromboembolism (VTE), and stroke were observed among the depressed cohort
Using a nationally representative cohort, this population-based study aimed at studying the trends in the frequency of CVD among depressed young adults (18-39 years) and understanding the differences between young adults with and without depression in terms of socio-demographics, hospital characteristic, and comorbid cardiovascular conditions

Summary

Introduction

Depression and cardiovascular disease (CVD) are known to be the leading causes of disability worldwide [1]. Depression has been found to be an independent risk factor of mortality and re-hospitalization or reinfarction in patients with known CVD in prior etiological and longitudinal studies; contemporary large-scale data remains limited [2,3,4,5]. Plausible mechanisms such as autonomic nervous system dysfunction, altered platelet receptor functioning, and pro-inflammatory cytokines, through which depression can influence the etiology and outcome in CVD, have been studied [6,7,8]. Modern-day studies that assess temporal trends in cardiovascular and cerebrovascular events (CCE) and outcomes among the young population in the United States (US) with depression remain limited

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Conclusion