Readmissions for Depression and Suicide Attempt following Stroke and Myocardial Infarction

Abstract

Background and Purpose: Rates of depression after ischemic stroke (IS) and myocardial infarction (MI) are significantly higher than in the general population and associated with morbidity and mortality. There is a lack of nationally representative data comparing depression and suicide attempt (SA) after these distinct ischemic vascular events. Methods: The 2013 Nationwide Readmissions Database contains > 14 million US admissions for all payers and the uninsured. Using International Classification of Disease, 9th Revision, Clinical Modification Codes, we identified index admission with IS (n = 434,495) or MI (n = 539,550) and readmission for depression or SA. We calculated weighted frequencies of readmission. We performed adjusted Cox regression to calculate hazard ratio (HR) for readmission for depression and SA up to 1 year following IS versus MI. Analyses were stratified by discharge home versus elsewhere. Results: Weighted depression readmission rates were higher at 30, 60, and 90 days in patients with IS versus MI (0.04%, 0.09%, 0.12% vs. 0.03%, 0.05%, 0.07%, respectively). There was no significant difference in SA readmissions between groups. The adjusted HR for readmission due to depression was 1.49 for IS versus MI (95% CI 1.25-1.79, p < 0.0001). History of depression (HR 3.70 [3.07-4.46]), alcoholism (2.04 [1.34-3.09]), and smoking (1.38 [1.15-1.64]) were associated with increased risk of depression readmission. Age > 70 years (0.46 [0.37-0.56]) and discharge home (0.69 [0.57-0.83]) were associated with reduced hazards of readmission due to depression. Conclusions: IS was associated with greater hazard of readmission due to depres

Exploring the shared experiences of people with stroke and caregivers in preparedness to manage post‐discharge care: A hermeneutic study

“…Hospital readmissions can be prevented through timely detection of mental disorders, psychological and emotional stress and individualized support for patient and caregiver populations (Denham et al, 2020;Stein et al, 2020). A study by Chung et al (2016) suggested that strategies building on dyadic members' strengths in preventing post-stroke depression are imperative.…”

“…Depression and anxiety affect approximately 30% and 25% of the stroke population respectively and contribute to poor mental health and quality of life, high mortality rates and prolonged disabilities (Medeiros et al, 2020; Minshall et al, 2020). Mental stress along with post‐stroke disabilities adds vulnerabilities to people with stroke developing adverse events after discharge and increasing hospital readmissions (Stein et al, 2020). Studies also indicated that caregivers experienced high‐levels of emotional stress from this sudden family crisis and 40%–60% showed depression which affected their ability to undertake and sustain the caregiving role (Mou et al, 2021).…”

“…Studies also indicated that caregivers experienced high‐levels of emotional stress from this sudden family crisis and 40%–60% showed depression which affected their ability to undertake and sustain the caregiving role (Mou et al, 2021). Hospital readmissions can be prevented through timely detection of mental disorders, psychological and emotional stress and individualized support for patient and caregiver populations (Denham et al, 2020; Stein et al, 2020). A study by Chung et al (2016) suggested that strategies building on dyadic members' strengths in preventing post‐stroke depression are imperative.…”

Association of Posttraumatic Stress Disorder and Race on Readmissions After Stroke

“…They found that not only was depression after stroke more likely to lead to readmission but that the risk was greater than with depression after myocardial infarction. 28 In our veteran cohort, veterans with PTSD had increased readmissions compared with those without PTSD. A racial disparity was also seen with African American veterans having higher risk for readmission compared with White veterans.…”

Impact of the mindfulness‐based psychoeducation applied to people having a myocardial infarction on mindfulness and posttraumatic growth

“…It threatens the life and wellbeing of the individual, and though it can be survived with emergency intervention it requires a lifestyle change after recovery (Sepehrian et al, 2020; Thygesen et al, 2019). It has been stated that individuals who have suffered an MI experience negative emotions such as stress (Farmer et al, 2020), anxiety (Karlsen et al, 2021), fear of death (Yıldırım & Kocatepe, 2021), fear of shortness of breath (Alcántara et al, 2020), kinesiophobia (Bäck et al, 2020), mental disorders such as depression (Stein et al, 2020) and posttraumatic stress disorder (Jacquet‐Smailovic et al, 2021), physical disorders such as chest pain and shortness of breath (Gwaltney et al, 2017) and loss of motivation (Hanna et al, 2020). MI is a traumatic experience as it may lead to death.…”