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- W2897820189 abstract "Introduction: Intravenous thrombolysis (IVT) improves outcomes after acute ischemic strokes (AIS) but is underutilized in vulnerable patients such as racial minorities, women, and those with low income. At the same time, mental illness affects 20% of U.S. adults, and these individuals are more likely than those without mental illness to experience inequities in treatment for a range of medical conditions, and are more likely to die within a year if they have a stroke. We aimed to determine if comorbid psychiatric disease is associated with differences in IVT use in AIS. Methods: We studied AIS admissions, identified by ICD9-CM codes, from 2007-2011 in the Nationwide Inpatient Sample. Psychiatric disease was defined by ICD9-CM codes for secondary diagnoses of schizophrenia or other psychoses, anxiety, depression, or bipolar disorder. We used logistic regression to test the association between IVT and psychiatric disease, controlling for demographic, clinical, and hospital factors. Results: In total, 335,923 AIS cases met inclusion criteria, of which 12.8% had any of the specified psychiatric comorbidities. IVT was used in 3.6% of those with, and 4.5% of those without, comorbid psychiatric disease ( p < 0.001). In multivariable logistic regression, having any psychiatric disease was associated with 20% decreased odds of receiving IVT (OR 0.80, 95% CI 0.76-0.85, Table 1). When each psychiatric diagnosis was analyzed separately, schizophrenia and other psychoses, anxiety, and depression were associated with significantly lower odds of receiving IVT (Table 1). Conclusions: AIS patients with comorbid psychiatric disease have significantly lower odds of receiving IVT. Understanding barriers to IVT use in such patients may help in developing interventions aimed at improving outcomes and increasing access to evidence-based stroke care." @default.
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- W2897820189 date "2018-01-22" @default.
- W2897820189 modified "2023-09-28" @default.
- W2897820189 title "Abstract 196: Comorbid Psychiatric Disease is Associated With Lower Rates of Thrombolysis in Ischemic Stroke" @default.
- W2897820189 doi "https://doi.org/10.1161/str.49.suppl_1.196" @default.
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