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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Mental disorders and revascularization procedures in a commercially insured sample.
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Mental disorders and revascularization procedures in a commercially insured sample.

机译：商业保险样品中的精神障碍和血运重建程序。

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OBJECTIVE: The objective of this study was to determine if receipt of revascularization was similar among commercially insured adults with mental disorders compared with people without mental disorders. METHODS: This was a retrospective analysis of a 100% sample of Blue Cross/Blue Shield of Iowa administrative claims data, 1996 to 2001. Logistic regression was used to calculate unadjusted and adjusted odds ratios (OR) for receipt of angioplasty (PTCA) and bypass graft surgery (CABG) within 30 days of discharge. RESULTS: A total of 3368 adults, aged 18 to 64 years, were hospitalized for myocardial infarction (MI) and 40% (n = 1342) had a mental disorder. Subjects with mental disorders were more likely to be younger, female, urban residents, and to have increased cardiovascular and medical comorbidity. They were similarly likely as subjects without mental disorders to have received PTCA (OR, 1.10; 95% confidence interval [CI], 0.95-1.29) and CABG (OR, 0.89; 95% CI, 0.71-1.11) in analyses adjusted for demographic and clinical characteristics. Revascularization rates did not differ by mental disorder type, with few exceptions. CONCLUSIONS: Receipt of revascularization was similar for patients with and without mental disorders. Our results may differ from previous findings as a result of the younger population studied and increased comorbidity in people with mental disorders, which may have resulted in a contraindication for surgical intervention. Conversely, the increased burden of comorbidity could suggest that these patients should have received PTCA at higher rates because of the better prognosis associated with revascularization as compared with medical management. Prospective analyses with review of clinical data and behavioral risk factors are necessary to determine why some patients with mental illness may be less likely to receive cardiac interventions.
机译：目的：本研究的目的是确定与没有精神障碍的人相比，商业上有精神障碍的成年人中血运重建的接受情况是否相似。方法：这是对1996年至2001年衣阿华州行政诉讼数据的Blue Cross / Blue Shield的100％样本的回顾性分析。采用逻辑回归分析来计算接受血管成形术（PTCA）和接受血管成形术（PTCA）的未调整和调整后的优势比（OR）。出院后30天内进行旁路移植手术（CABG）。结果：总共3368名年龄在18至64岁的成年人因心肌梗塞（MI）入院治疗，其中40％（n = 1342）有精神障碍。患有精神疾病的受试者更有可能是年轻的，女性，城市居民，以及心血管和医学合并症增加。与没有精神障碍的受试者相似，他们在针对人群调整的分析中接受了PTCA（OR，1.10; 95％置信区间[CI]，0.95-1.29）和CABG（OR，0.89; 95％CI，0.71-1.11）。和临床特征。除少数例外，血运重建率随精神障碍类型无差异。结论：有和没有精神障碍的患者血运重建的接受率相似。我们的结果可能与以前的发现有所不同，这是因为研究的人群较年轻，精神障碍患者的合并症增加，这可能导致外科手术的禁忌症。相反，合并症的负担增加可能表明这些患者应接受更高的PTCA治疗，因为与药物治疗相比，与血运重建相关的预后更好。回顾临床数据和行为危险因素进行前瞻性分析对于确定为什么某些精神疾病患者不太可能接受心脏干预的必要性。

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