Mortality after inpatient psychiatric discharge is a major concern and can occur due to both unnatural (e.g., suicide) and unnatural (e.g., vascular disease). In this meta-analysis, the authors looked at short- and long-term causes of mortality after inpatient psychiatric discharge. In the short-term period (0-2 years) following discharge, mortality rates due to unnatural causes (including suicide) were equivalent to mortality rates from natural causes (including vascular disease). However, after 5 years following discharge, mortality rate due to vascular disease far exceeded mortality from suicide and was approximately 2.5X greater than mortality rate due to vascular disease seen in the general population. The authors conclude that as time following discharge progresses risk of death due to suicide declines while risk of death to vascular disease remains relatively stable. These data may help to inform clinical practice and encourage clinicians to be mindful of their patients' cardiovascular health as well as suicide risk after inpatient psychiatric discharge (Figure). This may be especially important when choosing a psychotropic medication as many of these agents can have adverse cardiometabolic effects.
Swaraj S et al. Acta Psychiatr Scand 2019; Epub ahead of print. Abstract
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