Medical and Economic Costs of Psychologic Distress in Patients With Coronary Artery Disease
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BACKGROUND
Factors such as psychologic distress,1, 2, 3 depression,4, 5 and social isolation’1, 6, 7 have been shown to be independently associated with total mortality and cardiac death in patients with substantiated coronary artery disease. In addition, intervention for psychologic distress2, 3, 8 has been shown to decrease mortality after myocardial infarction.
To date, in only one previously published study in which psychologic distress was measured were all recurrent events and cardiovascular
PATIENTS AND METHODS
Study Group.—The study group consisted of 381 consecutive patients (311 men and 70 women) with coronary artery disease referred for cardiac rehabilitation after an index cardiac hospitalization.
Cardiac Rehabilitation.—The usual management during cardiac rehabilitation included monitored exercise sessions scheduled one to three times each week for approximately 6 to 12 weeks. Lectures on medications, exercise, stress reduction, and diet for the patients plus a special discussion group for both
RESULTS
Subject Characteristics.—The ages of patients in the study group ranged from 28 to 85 years. The index events included the following: unstable angina, 19; myocardial infarction, 73; emergent coronary angioplasty, 13; coronary artery bypass grafting, 118; myocardial infarction and angioplasty, 100; myocardial infarction and bypass surgical procedure, 45; angioplasty and bypass surgical procedure, 5; and myocardial infarction, angioplasty, and bypass surgical procedure, 8. The patients completed
DISCUSSION
The principal new finding in this study is that psychologic distress was associated with higher rehospitalization costs within 6 months after dismissal from an index hospitalization. Although new hard events were more common in the distressed than in the nondistressed patients during the 6 months of follow-up, we also found an excess of soft events and rehospitalizations in which no event occurred but which contributed, nonetheless, to the higher rehospitalization costs. Previous studies have
ACKNOWLEDGMENT
We thank Shawn E. Harris, Laurie L. Mather, and Candace L. Carlstrom for assistance with the data acquisition and analvsis.
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Exercise Counteracts the Cardiotoxicity of Psychosocial Stress
2019, Mayo Clinic ProceedingsHospital costs associated with depression in a cohort of older men living in Western Australia
2014, General Hospital PsychiatryCitation Excerpt :These figures do not include secondary costs associated with physical comorbidities and general hospital admissions. An association between depression and hospital admission has been postulated before [2–5], but few studies have quantified the potential economic impact of this association and mostly focusing on clinical populations rather than adults living in the community [6–9]. The aim of the study was to investigate differences in costs associated with general hospital admissions between community-dwelling older men with and without clinically significant depressive symptoms and to estimate to what extent these excess costs were due to depression.
Economics of psychosocial factors in patients with cardiovascular disease
2013, Progress in Cardiovascular DiseasesPsychiatric comorbidity in cardiovascular inpatients: Costs, net gain, and length of hospitalization
2011, Journal of Psychosomatic Research
This study was supported in part by the Mayo Foundation.
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Current address: San Diego State University, San Diego, California.