Acute ischemic stroke patients with comorbid psychiatric disease have significantly lower odds of intravenous thrombolysis (IVT), according to a recent study. Understanding barriers to IVT use in such patients may help in developing interventions to increase access to evidence-based stroke care. Acute ischemic stroke admissions between 2007 and 2011 were identified in the Nationwide Inpatient Sample. Psychiatric disease was defined by International Classification of Diseases, Ninth Revision, Clinical Modification codes for secondary diagnoses of schizophrenia or other psychoses, bipolar disorder, depression, or anxiety. Using logistic regression, researchers tested the association between IVT and psychiatric disease, controlling for demographic, clinical, and hospital factors. They found:
- Of the 325,009 ischemic stroke cases meeting inclusion criteria, 12.8% had any of the specified psychiatric comorbidities.
- IVT was used in 3.6% of those with, and 4.4% of those without, psychiatric disease.
- Presence of any psychiatric disease was associated with lower odds of receiving IVT.
- When psychiatric diagnoses were analyzed separately, individuals with schizophrenia or other psychoses, anxiety, or depression each had significantly lower odds of IVT compared to individuals without psychiatric disease.
Bongiorno DM, Daumit GL, Gottesman RF, Faigle R. Comorbid psychiatric disease is associated with lower rates of thrombolysis in ischemic stroke. [Published online ahead of print January 26, 2018]. Stroke. doi:10.1161/STROKEAHA.117.020295.
This Week's Must Reads
Fully Automated Test Gauges Processing Speed in MS, MS Mult Scler; ePub 2018 Aug 6; Patel, Shen, et al
Inflammation and Disability in Progressive-Onset MS, JAMA Neurology; ePub 2018 Aug 6; Hughes, et al
Mental Health’s Impact on Falls in Patients with MS, Mult Scler Relat Disord; ePub 2018 Jul 26; Kalron, et al
House-Call-Based Practice Viable for Advanced MS, Int J MS Care; ePub 2018 Aug 7; Healey, Zabad, et al
Detection of Chronic Active MS Lesions on 3T MRI, AJNR Am J Neuroradiol; 2018 Jul; Absinta, et al
Must Reads in Mixed Topics
Spatial Heterogeneity of White Matter Lesions , Neurology; ePub 2018 Aug 3; Habes, et al
Admissions for Psychotic Episodes, Epilepsy Linked , Epilepsia; ePub 2018 Jul 4; Rossi, Kim, et al
Gender and Cognition in Overweight Adults with T2D, Alzheimers Dement; ePub 2018 Jul 4; Espeland, et al
Anxiety Independently Associated with Epilepsy, Epilepsy Behav; ePub 2018 Jun 12; Clary, et al
Epilepsy, Fertility, and Birth Outcomes Examined , JAMA Neurology; ePub 2018 Apr 30; Pennell, et al