Mortality in patients with schizophrenia admitted for incident ischemic stroke: A population-based cohort study

Eur Neuropsychopharmacol. 2020 Feb:31:152-157. doi: 10.1016/j.euroneuro.2019.12.107. Epub 2019 Dec 26.

Abstract

Evidence shows that schizophrenia is associated with increased incidence of stroke. However, relationship between schizophrenia and short-term mortality risk is understudied, and mixed findings were observed. In this retrospective population-based cohort study, we identified individuals admitted for incident ischemic stroke between 2006 and 2016 using a territory-wide electronic medical record database of public healthcare system in Hong Kong to examine 30-day and 1-year mortality rates in 817 schizophrenia patients compared with 8170 patients without psychotic disorder (10:1 matched to schizophrenia patients on demographics, treatment sites and calendar-period for index admission). Multivariate regression analyses adjusting for medical comorbidities revealed that schizophrenia patients experienced elevated 1-year (16.9% vs 12.1%; p < 0.001) and 30-day mortality (7.2% vs 5.3%; p = 0.053) relative to control group. Additional age- and gender-stratified analyses revealed even more pronounced effect of schizophrenia on raised mortality risk, as indicated by higher odds, in younger-age (<65 years) group and men. Our results indicate that schizophrenia is associated with heightened short-term mortality following incident ischemic stroke. Further research is warranted to identify factors contributing to excess post-stroke deaths among schizophrenia patients to facilitate development of effective interventions for mortality risk reduction.

Keywords: Ischemic stroke; Mortality; Population-based study; Schizophrenia; Stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brain Ischemia / diagnosis
  • Brain Ischemia / mortality*
  • Brain Ischemia / therapy
  • Cohort Studies
  • Data Analysis*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Mortality / trends
  • Patient Admission / trends*
  • Population Surveillance*
  • Retrospective Studies
  • Schizophrenia / diagnosis
  • Schizophrenia / mortality*
  • Schizophrenia / therapy
  • Stroke / diagnosis
  • Stroke / mortality*
  • Stroke / therapy