Impact of anxiety on the post-discharge outcomes of patients discharged from the hospital after an acute coronary syndrome
Symptoms of anxiety are highly prevalent among survivors of an acute coronary syndrome (ACS), but do not necessarily indicate an anxiety disorder. The extent to which symptoms of anxiety or a diagnosis of this condition impacts hospital readmission and post-discharge mortality among patients with an...
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Published in | International journal of cardiology Vol. 278; pp. 28 - 33 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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Elsevier B.V
01.03.2019
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Abstract | Symptoms of anxiety are highly prevalent among survivors of an acute coronary syndrome (ACS), but do not necessarily indicate an anxiety disorder. The extent to which symptoms of anxiety or a diagnosis of this condition impacts hospital readmission and post-discharge mortality among patients with an ACS remains unclear.
We used data from 1909 patients discharged from six hospitals in Massachusetts and Georgia after an ACS. Moderate/severe symptoms of anxiety were defined based on responses to a Generalized Anxiety Disorder questionnaire during the patient's index hospitalization. The diagnosis of an anxiety disorder was based on review of hospital medical records. Multivariable adjusted Poisson regression and Cox proportional-hazards models were used to estimate the risk of 30-day hospital readmissions and 2-year total mortality.
The mean age of the study population was 61 years, two thirds were men, and 78% were non-Hispanic whites. In this population, 10.4% had a documented diagnosis of an anxiety disorder, 18.8% had moderate/severe symptoms of anxiety, and 70.8% had neither a diagnosis nor symptoms of anxiety. Neither a diagnosis of an anxiety disorder nor symptoms of anxiety were associated with 30-day all-cause or cardiovascular-related rehospitalizations. Patients with an anxiety disorder (multivariable adjusted HR = 1.95, 95%CI = 1.11–3.42) were at greatest risk for dying during the 2-year follow-up period.
We identified patients with an anxiety disorder as being at greater risk for dying after hospital discharge for an ACS. Interventions may be more appropriately targeted to those with a history of, rather than acute symptoms of, anxiety.
•Symptoms of anxiety are prevalent among hospital survivors of an acute coronary syndrome (ACS)•Anxiety symptoms or established anxiety disorder were not associated with 30 day all-cause or CVD-related rehospitalization•Established anxiety disorder, but not anxiety symptoms, were associated with higher mortality risk over 2 years of follow-up |
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AbstractList | Symptoms of anxiety are highly prevalent among survivors of an acute coronary syndrome (ACS), but do not necessarily indicate an anxiety disorder. The extent to which symptoms of anxiety or a diagnosis of this condition impacts hospital readmission and post-discharge mortality among patients with an ACS remains unclear.
We used data from 1909 patients discharged from six hospitals in Massachusetts and Georgia after an ACS. Moderate/severe symptoms of anxiety were defined based on responses to a Generalized Anxiety Disorder questionnaire during the patient's index hospitalization. The diagnosis of an anxiety disorder was based on review of hospital medical records. Multivariable adjusted Poisson regression and Cox proportional-hazards models were used to estimate the risk of 30-day hospital readmissions and 2-year total mortality.
The mean age of the study population was 61 years, two thirds were men, and 78% were non-Hispanic whites. In this population, 10.4% had a documented diagnosis of an anxiety disorder, 18.8% had moderate/severe symptoms of anxiety, and 70.8% had neither a diagnosis nor symptoms of anxiety. Neither a diagnosis of an anxiety disorder nor symptoms of anxiety were associated with 30-day all-cause or cardiovascular-related rehospitalizations. Patients with an anxiety disorder (multivariable adjusted HR = 1.95, 95%CI = 1.11-3.42) were at greatest risk for dying during the 2-year follow-up period.
We identified patients with an anxiety disorder as being at greater risk for dying after hospital discharge for an ACS. Interventions may be more appropriately targeted to those with a history of, rather than acute symptoms of, anxiety. Symptoms of anxiety are highly prevalent among survivors of an acute coronary syndrome (ACS), but do not necessarily indicate an anxiety disorder. The extent to which symptoms of anxiety or a diagnosis of this condition impacts hospital readmission and post-discharge mortality among patients with an ACS remains unclear. We used data from 1909 patients discharged from six hospitals in Massachusetts and Georgia after an ACS. Moderate/severe symptoms of anxiety were defined based on responses to a Generalized Anxiety Disorder questionnaire during the patient's index hospitalization. The diagnosis of an anxiety disorder was based on review of hospital medical records. Multivariable adjusted Poisson regression and Cox proportional-hazards models were used to estimate the risk of 30-day hospital readmissions and 2-year total mortality. The mean age of the study population was 61 years, two thirds were men, and 78% were non-Hispanic whites. In this population, 10.4% had a documented diagnosis of an anxiety disorder, 18.8% had moderate/severe symptoms of anxiety, and 70.8% had neither a diagnosis nor symptoms of anxiety. Neither a diagnosis of an anxiety disorder nor symptoms of anxiety were associated with 30-day all-cause or cardiovascular-related rehospitalizations. Patients with an anxiety disorder (multivariable adjusted HR = 1.95, 95%CI = 1.11–3.42) were at greatest risk for dying during the 2-year follow-up period. We identified patients with an anxiety disorder as being at greater risk for dying after hospital discharge for an ACS. Interventions may be more appropriately targeted to those with a history of, rather than acute symptoms of, anxiety. •Symptoms of anxiety are prevalent among hospital survivors of an acute coronary syndrome (ACS)•Anxiety symptoms or established anxiety disorder were not associated with 30 day all-cause or CVD-related rehospitalization•Established anxiety disorder, but not anxiety symptoms, were associated with higher mortality risk over 2 years of follow-up BACKGROUNDSymptoms of anxiety are highly prevalent among survivors of an acute coronary syndrome (ACS), but do not necessarily indicate an anxiety disorder. The extent to which symptoms of anxiety or a diagnosis of this condition impacts hospital readmission and post-discharge mortality among patients with an ACS remains unclear. METHODSWe used data from 1909 patients discharged from six hospitals in Massachusetts and Georgia after an ACS. Moderate/severe symptoms of anxiety were defined based on responses to a Generalized Anxiety Disorder questionnaire during the patient's index hospitalization. The diagnosis of an anxiety disorder was based on review of hospital medical records. Multivariable adjusted Poisson regression and Cox proportional-hazards models were used to estimate the risk of 30-day hospital readmissions and 2-year total mortality. RESULTSThe mean age of the study population was 61 years, two thirds were men, and 78% were non-Hispanic whites. In this population, 10.4% had a documented diagnosis of an anxiety disorder, 18.8% had moderate/severe symptoms of anxiety, and 70.8% had neither a diagnosis nor symptoms of anxiety. Neither a diagnosis of an anxiety disorder nor symptoms of anxiety were associated with 30-day all-cause or cardiovascular-related rehospitalizations. Patients with an anxiety disorder (multivariable adjusted HR = 1.95, 95%CI = 1.11-3.42) were at greatest risk for dying during the 2-year follow-up period. CONCLUSIONSWe identified patients with an anxiety disorder as being at greater risk for dying after hospital discharge for an ACS. Interventions may be more appropriately targeted to those with a history of, rather than acute symptoms of, anxiety. |
Author | Tran, Hoang Saczynski, Jane Kiefe, Catarina Erskine, Nathaniel Byatt, Nancy Lessard, Darleen Goldberg, Robert Devereaux, Randolph S. |
Author_xml | – sequence: 1 givenname: Hoang surname: Tran fullname: Tran, Hoang organization: Department of Quantitative Health Sciences, University of Massachusetts Medical School, United States of America – sequence: 2 givenname: Nancy surname: Byatt fullname: Byatt, Nancy organization: Department of Psychiatry, University of Massachusetts Medical School, United States of America – sequence: 3 givenname: Nathaniel surname: Erskine fullname: Erskine, Nathaniel organization: Department of Quantitative Health Sciences, University of Massachusetts Medical School, United States of America – sequence: 4 givenname: Darleen surname: Lessard fullname: Lessard, Darleen organization: Department of Quantitative Health Sciences, University of Massachusetts Medical School, United States of America – sequence: 5 givenname: Randolph S. surname: Devereaux fullname: Devereaux, Randolph S. organization: Department of Community Medicine, Mercer University School of Medicine, United States of America – sequence: 6 givenname: Jane surname: Saczynski fullname: Saczynski, Jane organization: Department of Pharmacy and Health System Sciences, Northeastern University, United States of America – sequence: 7 givenname: Catarina surname: Kiefe fullname: Kiefe, Catarina organization: Department of Quantitative Health Sciences, University of Massachusetts Medical School, United States of America – sequence: 8 givenname: Robert orcidid: 0000-0001-7705-7740 surname: Goldberg fullname: Goldberg, Robert email: Robert.goldberg@umassmed.edu organization: Department of Quantitative Health Sciences, University of Massachusetts Medical School, United States of America |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30266354$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1136_bmjopen_2019_034135 crossref_primary_10_1016_j_jpsychores_2023_111328 crossref_primary_10_1016_j_ijcard_2018_12_010 crossref_primary_10_1016_j_jpsychores_2022_111141 crossref_primary_10_1136_bmjopen_2023_079298 crossref_primary_10_59398_ahd_1268478 |
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Keywords | Anxiety Rehospitalization Acute coronary syndrome Mortality |
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Snippet | Symptoms of anxiety are highly prevalent among survivors of an acute coronary syndrome (ACS), but do not necessarily indicate an anxiety disorder. The extent... BACKGROUNDSymptoms of anxiety are highly prevalent among survivors of an acute coronary syndrome (ACS), but do not necessarily indicate an anxiety disorder.... |
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SubjectTerms | Acute coronary syndrome Anxiety Mortality Rehospitalization |
Title | Impact of anxiety on the post-discharge outcomes of patients discharged from the hospital after an acute coronary syndrome |
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