Introduction Non-cardiac chest pain (NCCP) is considered a benign condition, associated with a low mortality rate. Contemporary population based studies describing outcomes in NCCP are lacking however. To our knowledge, the relationship between psychiatric disorders and survival in patients with NCCP has not been investigated. This data linkage study investigated case-fatality following a first hospitalisation for NCCP and examined the effect of a previous psychiatric hospitalisation on short-term all-cause and CVD specific mortality.
Methods A population-based retrospective cohort study of 159 888 patients discharged from hospital in Scotland (1991–2006) following a first hospitalisation for NCCP using routinely collected hospital morbidity and mortality data. All-cause and cardiovascular disease (CVD) mortality at 1 year following hospitalisation was examined.
Results 4.4% (3514) of men and 3.9% (3136) of women with a first NCCP hospitalisation had a psychiatric hospitalisation in the 10 years preceding incident NCCP hospitalisation; those with a previous psychiatric hospitalisation were younger and more socioeconomically deprived (SED). Crude case-fatality at 1 year was higher in patients with a previous psychiatric hospitalisation compared to those without (men 6.3% vs 4.3%; women 5.4% vs 3.6%), in all age groups and all SED quintiles. Following adjustment (year of NCCP hospitalisation and SED), the hazard of all-cause and CVD-specific mortality at 1 year was higher in men and women with a previous psychiatric hospitalisation, and inversely related to age.
Conclusions Previous psychiatric hospitalisation should be considered in the risk stratification of patients discharged from hospital with a diagnosis of NCCP. Cardiovascular prevention strategies should target this hard to reach group.