title: Association between mental health conditions and rehospitalization, mortality, and functional outcomes in patients with stroke following inpatient rehabilitation.
abstract: BACKGROUND
  Limited evidence exists regarding the association of pre-existing mental health conditions in patients with stroke and stroke outcomes such as rehospitalization, mortality, and function. We examined the association between mental health conditions and rehospitalization, mortality, and functional outcomes in patients with stroke following inpatient rehabilitation.
  
  
  METHODS
  Our observational study used the 2001 VA Integrated Stroke Outcomes database of 2162 patients with stroke who underwent rehabilitation at a Veterans Affairs Medical Center. Separate models were fit to our outcome measures that included 6-month rehospitalization or death, 6-month mortality post-discharge, and functional outcomes post inpatient rehabilitation as a function of number and type of mental health conditions. The models controlled for patient socio-demographics, length of stay, functional status, and rehabilitation setting.
  
  
  RESULTS
  Patients had an average age of 68 years. Patients with stroke and two or more mental health conditions were more likely to be readmitted or die compared to patients with no conditions (OR: 1.44, p = 0.04). Depression and anxiety were associated with a greater likelihood of rehospitalization or death (OR: 1.33, p = 0.04; OR:1.47, p = 0.03). Patients with anxiety were more likely to die at six months (OR: 2.49, p = 0.001).
  
  
  CONCLUSIONS
  Patients with stroke with pre-existing mental health conditions may need additional psychotherapy interventions, which may potentially improve stroke outcomes post-hospitalization.
authors.affiliation: Center for Health Quality, Outcomes, and Economic Research, ENRM VA Hospital, Bedford, MA, USA. adossa@bu.edu
authors.forename: Almas
authors.initials: A
authors.lastname: Dossa
authors.forename: Mark E
authors.initials: ME
authors.lastname: Glickman
authors.forename: Dan
authors.initials: D
authors.lastname: Berlowitz
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015897:Comorbidity; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008134:Long-Term Care; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D020127:Recovery of Function; D020521:Stroke / Q000453:epidemiology / Q000401:mortality; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs
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