Abstract

Failure to deliver the standard stroke care is suspected to be a potential reason for disproportionately high mortality among patients with co-morbid bipolar disorder (BD). Few studies have explored adverse outcomes and medical care costs concurrently (as a proxy for care intensity) among patients with BD admitted for stroke. Data for this nationwide population-based study were extracted from the Taiwan National Health Insurance Research Database, on 580 patients with BD hospitalized for stroke (the study group) and a comparison group consisting of randomly selected 1740 stroke patients without BD matched by propensity scores. Conditional logistic regression was used to estimate odds ratios (OR) for adverse in-hospital outcomes between study group and comparison group. We found that stroke patients with BD had significantly lower in-hospital mortality (3.28% vs. 5.63%), acute respiratory failure (2.59% vs. 5.57%), and use of mechanical ventilation (6.55% vs. 10.23%) than the comparison group. After adjusting for geographical location, urbanization level, monthly income, hypertension, diabetes, hyperlipidemia, and coronary heart disease, the odds of in-hospital mortality, acute respiratory failure, and use of mechanical ventilation in the BD group were 0.56 (95% CI: 0.34–0.92), 0.46 (95% CI: 0.26–0.80), and 0.63 (95% CI: 0.44–0.91), respectively. No differences were found in hospitalization costs and the length of hospital stay. With comparable hospitalization costs and length of hospital stay, we concluded that stroke patients with BD had lower in-hospital mortality and serious adverse events compared to stroke patients without BD.

Original languageEnglish
Article numbere0213072
JournalPLoS One
Volume14
Issue number3
DOIs
Publication statusPublished - Mar 1 2019

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Bipolar Disorder
stroke
Stroke
Length of Stay
Hospital Mortality
Artificial Respiration
Respiratory Insufficiency
Health insurance
Costs
Hospitalization
health insurance
Medical problems
Health care
Costs and Cost Analysis
Propensity Score
Geographical Locations
hyperlipidemia
Urbanization
Logistics
urbanization

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Adverse stroke outcomes among patients with bipolar disorder. / Chen, Pao Huan; Kao, Yi Wei; Shia, Ben Chang; Lin, Herng Ching; Kang, Jiunn Horng.

In: PLoS One, Vol. 14, No. 3, e0213072, 01.03.2019.

Research output: Contribution to journalArticle

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