Stroke mortality in patients with mental health disorders; a cohort study from the Spanish hospital discharge records.

INTRODUCTION

Evidence on the clinical outcomes of stroke for patients with psychiatric disorders is poor. It is also unclear if the prognosis of stroke has improved over the last two decades for those with mental health conditions. The aims of this study are first, to compare the hospital mortality between 2019 and 2023 of stroke for patients with and without depression, anxiety, schizophrenia, bipolar, or personality disorders, and second, to investigate whether the stroke mortality in 2019-2023 is lower than in 2005-2009, for those with psychiatric conditions.

METHODS

Data from all stroke patients registered in the Spanish Hospital Discharge Records were used. The variables registered for each patient include sociodemographics, mortality, and up to 20 diagnoses of past medical history. Multivariable logistic regression models were used in the analyses.

RESULTS

Between 2019 and 2023, 311528 patients were registered, of which, 14.40% died. Mortality of ischaemic stroke was higher for patients with schizophrenia OR(CI): 1.63(1. 30-2.04), bipolar OR(CI): 1.39(1. 10-1.77), or personality disorders OR(CI): 1.54(1. 13-2.09). The mortality of haemorrhagic stroke was increased for patients with schizophrenia OR(CI): 1.69(1. 29-2.23). There was a significant reduction in mortality of ischaemic and haemorrhagic stroke, for the whole population, between 2005 and 2009 and 2019-2023. There was no significant reduction in mortality of ischaemic stroke, for those with depression, anxiety, schizophrenia, bipolar, or personality disorders. There was no significant reduction in mortality of haemorrhagic stroke for patients with depression, schizophrenia, or bipolar disorders.

CONCLUSION

Psychiatric disorders are associated with higher stroke mortality, that has not declined between 2005 and 2009 and 2019-2023.