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.
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