Abstract
Byline: Gauravpal S Gill, Creighton Univ SOM, Omaha, NE; Isaac Burright, Creighton Univ SOM, Omaha, NE; Ryan Walters, Creighton Univ, Omaha, NE; Venkata Alla Background: Takotsubo (or stress) cardiomyopathy (TC) is a transient regional systolic dysfunction, clinically and echocardiographically resembling acute coronary syndrome (ACS) in the absence of obstructive coronary artery disease. The prevalence of psychiatric disorders is high in TC. However, it is unclear whether presence of underlying psychiatric condition impacts outcomes of TC. Methods: Hospitalizations for TC from 2012 to 2018 were identified using the National Inpatient Sample (NIS) and stratified by presence or absence of concomitant psychiatric diagnoses (major depression, dysthymia, anxiety, bipolar, substance abuse). Outcomes of interest included mortality, cardiac arrest, cardiogenic shock, intra-aortic balloon pump (IABP), mechanical ventilation, and length of stay. Differences in outcome rates were compared using the Rao-Scott chi-square test; length of stay was compared using a lognormal regression model. All analyses accounted for the NIS sampling design. Results: A total of 51,625 hospital discharges with TC were identified, of which 21,690 (42%) carried a psychiatric diagnosis. There were no statistically significant differences in mortality (1.2% vs. 1.6%; p=0.087), cardiac arrest (1.5% vs. 1.5%; p=0.853), cardiogenic shock (4.6% vs. 4.9%; p=0.427), IABP use (1.6% vs. 1.7%; p=0.695), mechanical ventilation (4.9% vs. 4.2%; p=0.113) for patients with and without psychiatric diagnosis, respectively. The length of stay among patients with psychiatric diagnosis, was marginally higher (median 3.7, IQR [3.6-3.8] days vs. 3.5 [3.4-3.6] days; p<0.01). Conclusion: Our analysis demonstrates that in-hospital mortality and complications of TC patients with and without psychiatric illness are statistically similar.