Adverse hospital events for mentally ill patients undergoing coronary artery bypass surgery

Health Serv Res. 2008 Dec;43(6):2239-52. doi: 10.1111/j.1475-6773.2008.00875.x. Epub 2008 Jul 28.


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.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Algorithms
  • Coronary Artery Bypass / adverse effects*
  • Female
  • Humans
  • Insurance Claim Review
  • Male
  • Mental Disorders*
  • Middle Aged
  • New York / epidemiology
  • Patients / psychology*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies