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VOLUME 43 | NUMBER 6 | DECEMBER 2008


Adverse Hospital Events for Mentally-Ill Patients Undergoing Coronary Artery Bypass Surgery

Context. Patients with mental disorders show higher burden of coronary heart disease, and may face special safety issues during in-hospital cardiac care.

Objectives. To compare the postoperative complication rate between patients with and without mental disorders undergoing isolated coronary artery bypass graft (CABG) surgery.

Design, Setting, and Patients. Retrospective analyses of New York state hospital claims between 1997 and 2004 (N=135,701). Complications were defined using the Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ PSI).

Principal Findings. Mental disorders were significantly associated with higher anesthesia complications (adjusted odds ratio [AOR]=6.44, p<.001), decubitus ulcer (AOR=1.42, p=.006), postoperative hip fracture (AOR=3.29, p<.001), and overall complication rate representing nine PSIs (AOR=1.27, p<.001).

Conclusions. Mentally ill patients undergoing CABG surgery are more likely to experience potentially preventable complications and injuries. The mechanism underlying this observation warrants further study.

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