Lower mortality among stroke patients with schizophrenia: a nationwide population-based study.
OBJECTIVE
To examine 90-day mortality among schizophrenia patients who suffered a recent stroke, using population-based data and a retrospective cohort design. Increasing evidence demonstrates a higher cardiovascular risk for schizophrenia patients compared with the general population. There are no data on stroke outcomes among schizophrenia patients.


METHODS
Data were derived from the Taiwan National Health Insurance Research Database and Cause of Death Data File in Taiwan. During 2002 to 2004, 485 schizophrenia patients hospitalized for stroke were identified. We randomly selected 2,425 stroke patients without schizophrenia who were matched to the study group on sex, age, intensive care unit admission, length of stay, and stroke type. Stratified Cox proportional hazard regressions stratified by age, sex, intensive care unit admission, length of stay, and stroke type were performed to compute the 90-day survival rate, after adjusting for demographic variables and selected medical comorbidities.


RESULTS
Among the 2,910 sampled patients, 258 patients (8.9%) died within 90 days of their index hospitalization, 18 (3.7%) from the study group and 240 (9.9%) from the comparison group (p < .001). After adjusting for demographic and comorbidity factors, stratified Cox proportional hazard regressions confirmed likewise showed that 90-day mortality was less likely among stroke patients with schizophrenia relative to stroke patients without schizophrenia (hazard ratio, 0.35; 95% confidence interval, 0.21-0.57; p < .001).


CONCLUSIONS
A 90-day mortality among acute stroke patients with schizophrenia is significantly lower than that of stroke patients without schizophrenia.
School of Health Care Administration, College of Public Health and Nutrition, Taipei Medical University, 250 Wu-Hsing St., Taipei 110, Taiwan.
Jiunn-Horng
JH
Kang
Sudha
S
Xirasagar
Herng-Ching
HC
Lin
D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality; D015897:Comorbidity; D005260:Female; D006801:Humans; D038801:International Classification of Diseases / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009313:National Health Programs / Q000706:statistics & numerical data / Q000639:trends; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology*; D020521:Stroke / Q000453:epidemiology / Q000401:mortality*; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology