Objective

Vascular surgery can be common among people with serious mental illness (SMI) given the high prevalence of cardiovascular disease. However, post-operative outcomes following vascular surgery have received little investigation, particularly in a subpopulation of SMI.

Methods

We conducted a retrospective observational study using data from the South London and Maudsley NHS Foundation Trust (SLaM) via its Clinical Record Interactive Search (CRIS) platform and linkage with Hospital Episode Statistic (HES). Vascular surgery recipients were identified using OPCS version 4 codes. Length of stay (LOS) was modelled using Incidence Rate Ratios (IRRs), and 30-day emergency hospital readmissions using Odds Ratios (ORs) for people with SMI compared with the general population.

Results

Vascular surgery was received by 152 patients with SMI diagnoses (schizophrenia, schizoaffective disorder, bipolar disorder) and 8821 catchment residents without any mental health conditions. People with active SMI symptoms more likely to be admitted to hospital via emergency route OR: 1.80 (95% CI: 1.06, 3.07) and more likely to stay longer in the hospital for vascular surgery IRR: 1.35 (1.01, 1.80) and more likely to be readmitted to hospital via emergency route within 30 days OR: 1.53 (1.02, 2.67). People with SMI who had major open vascular surgery and peripheral endovascular surgery more likely to have worse post-operative outcomes.

Conclusion

Our study highlights the risks faced by people with SMI following vascular surgery. These suggest tailored guidelines and policies are needed, based on the identification of pre-operative risk factors, allowing for focused post-vascular surgery care to minimise adverse outcomes.

中文翻译：

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严重精神疾病患者的血管手术收据和结果：利用伦敦南部大型精神保健数据库进行的回顾性队列研究

客观的

鉴于心血管疾病的高患病率，血管手术在严重精神疾病 (SMI) 患者中很常见。然而，血管手术后的术后结果很少受到调查，特别是在 SMI 亚群中。

方法

我们利用南伦敦和莫兹利 NHS 基金会信托基金 (SLaM) 的临床记录交互式搜索 (CRIS) 平台以及与医院发病统计 (HES) 的链接，进行了一项回顾性观察研究。使用 OPCS 版本 4 代码识别血管手术受者。与普通人群相比，SMI 患者的住院时间 (LOS) 使用发病率比 (IRR) 建模，30 天急诊再入院使用比值比 (OR) 建模。

结果

152 名 SMI 诊断患者（精神分裂症、分裂情感障碍、双相情感障碍）和 8821 名没有任何精神健康问题的学区居民接受了血管手术。患有活动性 SMI 症状的人更有可能通过紧急途径入院 OR：1.80（95% CI：1.06，3.07）并且更有可能在医院停留更长时间进行血管手术 IRR：1.35（1.01，1.80）并且更有可能在 30 天内通过紧急途径重新入院或：1.53 (1.02, 2.67)。接受过重大开放血管手术和外周血管内手术的 SMI 患者术后结果可能更差。

结论

我们的研究强调了 SMI 患者在血管手术后面临的风险。这些表明需要根据术前危险因素的识别制定量身定制的指南和政策，以便进行有针对性的血管手术后护理，以尽量减少不良后果。