Pulmonary embolism tied to excess risk for psychiatric disorders

  • Tzeng NS & al.
  • J Investig Med
  • 2 Jul 2019

  • International Clinical Digest
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Takeaway

  • People with pulmonary embolism (PE) are at risk for psychiatric disorders, including dementia, anxiety, depression, and sleep disorders, according to a nationwide cohort.

Why this matters

  • Clinicians should consider monitoring patients with PE for psychiatric disorders.
  • Mechanistic basis of link may trace to brain hypoxia with PE.

Study design

  • Retrospective population-based nationwide cohort (n=21,916 patients ≥20 years old with PE in 2000-2015 were compared with 65,748 control individuals without PE matched for sex and age) in the National Health Insurance Research Database of Taiwan.
  • Funding: Tri-Service General Hospital Research Foundation; others.

Key results

  • People with PE had a 70% increased risk for psychiatric disorders (aHR, 1.704; P<.001 including the following specific disorders:>
  • 56% increased risk for dementia (aHR, 1.563; P<.001>
  • 85% increased risk for anxiety (aHR, 1.854; P<.001>
  • 2-fold increased risk for depression (aHR, 2.040; P<.001>
  • Nearly 60% increased risk for sleep disorders (aHR, 1.597; P<.001>
  • No increased risk for bipolar or psychotic disorders.
  • Risks were similar (but more attenuated) if psychiatric diagnoses were excluded in the first year and in the first 5 years after the index PE.
  • Limitations

    • Reliance on health claims.
    • Findings may be limited to Asians.

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