History of Serious Mental Illness is a Predictor of Morbidity and Mortality in Cardiac Surgery.

Abstract Background Serious Mental Illness (SMI), defined as a mental disorder causing functional impairment, affects 9.8 million Americans. SMI correlates with earlier onset, more extensive cardiac disease, and reduced life expectancy by 25 years. The impact of SMI on patients undergoing cardiac surgery has not been extensively studied. We hypothesized patients with SMI have worse cardiac surgery outcomes. Methods Using our institution’s Society of Thoracic Surgeons database of 16,781 cardiac operations (2002-2017), a total of 1,445 patients (8.7%) were identified with SMI, and stratified into anxiety, mood disorders, and psychosis. The risk-adjusted impact on morbidity and mortality were evaluated using multivariable regression. Results Patients with SMI were more often female, younger, and had more comorbid disease. SMI patients were more likely to have had previous cardiac surgery and require urgent/emergent procedures (both p Conclusions Serious Mental Illness is independently associated with morbidity and mortality after cardiac surgery. SMI patients, especially the subset with psychosis, are complicated, high-risk, and resource-consuming. Refined strategies to reduce postoperative complications and improve care coordination are necessary in this population.