European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S238–S302 S247
(aOR 1.695; 95%CI 1.650–1.741; P < 0.001). In addition, median
length of hospitalization (2.5 vs. 2.13 days; P < 0.001) and median
cost of hospitalization (28,246 vs. 22,663; P < 0.001) was higher in
hospitalizations with MDD.
Conclusions Our study displayed an increasing proportion of
patients withMDD admitted due to AF in the last decadewith lower
mortality but higher morbidity post-AF. In addition, there was sig-
nificantly less utilization of atrial cardioversion in this population
along with higher median length and cost of hospitalization. There
is a need to explore the reasons behind this disparity in outcomes
and atrial cardioversion utilization in order to improve post-AF
outcomes in this vulnerable population.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0414
Temporal trends in drug abuse in
adults with acute myocardial
infarction show worse outcomes
Z. Mansuri ∗, S. Patel , P. Patel , O. Jayeola , A. Das , J. Shah ,
M.H. Gul , K. Karnik , A. Ganti , R. Patel
1 Texas Tech University Health Sciences Center Permian Basin
Campus, Psychiatry, Odessa, USA
2 Icahn School of Medicine at Mount Sinai, Public Health, New York,
USA
3 Windsor University School of Medicine, Public Health, Monee, USA
4 Drexel University School of Public Health, Public Health,
Philadephia, USA
5 Florida Hospital, Internal Medicine, Orlando, USA
6 Pramukhswami Medical College, Internal Medicine, Karamsad, India
7 St. Louis University Hospital, Nephrology, St. Louis, USA
8 Children’s Hospital of San Antonio, Public Health, San Antonio, USA
9 Suburban Medical Center, Internal Medicine, Schaumburg, USA
10 Acardia University, Public Health, Glenside, USA
∗ Corresponding author.
Objective To determine temporal trends, invasive treatment uti-
lization and impact on outcomes of pre-infarction drug abuse (DA)
on acute myocardial infarction (AMI) in adults.
Background DA is important risk factor for AMI. However, tempo-
ral trends in drug abuse on AMI hospitalization outcomes in adults
are lacking.
Methods We used Nationwide Inpatient Sample (NIS) from
Healthcare Cost and Utilization Project (HCUP) from 2002 to 2012.
We identified AMI and DA as primary and secondary diagnosis
respectively using validated International Classification of Dis-
eases, 9th Revision, and Clinical Modification (ICD9CM) codes, and
used the CochraneArmitage trend test and multivariate regression
to generate adjusted odds ratios (aOR).
Results We analyzed total of 7,174,274 AMI hospital admissions
from 2002 to 2012 of which 1.67% had DA. Proportion of hospital-
izations with DA increased from 5.63% to 12.08% (P trend < 0.001).
Utilization of coronary artery bypass grafting (CABG) was lower in
patients with DA (7.83% vs. 9.18%, P < 0.001). In-hospital mortal-
ity was significantly lower in patients with DA (aOR 0.811; 95% CI
0.693–0.735; P < 0.001) but discharge to specialty care was higher
(aOR 1.076; 95% CI 1.025–1.128; P < 0.001). The median cost of
hospitalization (40,834 vs. 37,253; P < 0.001) was higher in hospi-
talizations with DA.
Conclusions We demonstrate an increasing proportion of adults
admittedwithAMI haveDA over the decade. However, DAhas para-
doxical association with mortality in adults. DA is associated with
lower CABG utilization and higher discharge to specialty care, with
a higher mean cost of hospitalization. The reasons for the paradoxi-
cal association of DAwithmortality andworsemorbidity outcomes
need to be explored in greater detail.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0415
Increased prevalence of psychosis in
patients who get admitted with acute
myocardial infarction with worse
outcomes
Z. Mansuri ∗, S. Patel , P. Patel , O. Jayeola , A. Das , J. Shah ,
M.H. Gul , K. Karnik , A. Ganti , K. Shah
1 Texas Tech University Health Sciences Center Permian Basin
Campus, Psychiatry, Odessa, TX, USA
2 Icahn School of Medicine at Mount Sinai, Public Health, New York,
USA
3 Windsor University School of Medicine, Public Health, Monee, USA
4 Drexel University School of Public Health, Public Health,
Philadelphia, USA
5 Florida Hospital, Internal Medicine, Orlando, USA
6 Pramukhswami Medical College, Internal Medicine, Karamsad, USA
7 St. Louis University Hospital, Nephrology, St. Louis, USA
8 Children’s Hospital of San Antonio, Public Health, San Antonio, USA
9 Suburban Medical Center, Internal Medicine, Schaumburg, USA
10 Kentucky University, Public Health, Bowling Green, USA
∗ Corresponding author.
Objective To determine trends and impact on outcomes of acute
myocardial infarction (AMI) in patients with pre-existing psy-
chosis.
Background While post-AMI psychosis has been extensively
studied, contemporary studies including temporal trends on
impact of pre-AMI Psychosis on AMI and post-AMI outcomes are
lacking.
Methods We used Nationwide Inpatient Sample (NIS) from
Healthcare Cost and Utilization Project(HCUP) from 2002 to 2012.
We identified AMI and psychosis as primary and secondary diag-
nosis respectively using validated International Classification of
Diseases, 9th Revision, and Clinical Modification (ICD9CM) codes,
and Cochrane-Armitage trend test and multivariate regression to
generate adjusted odds ratios (aOR).
Results We analyzed total of 7,174,274 AMI hospital admissions
from 2002 to 2012 of which 1.77% had psychosis. Proportion of
hospitalizations with psychosis increased from 6.94% to 11.85%
(P-trend < 0.001). Utilization of percutaneous coronary interven-
tion (PCI) was lower in patients with psychosis (29.98% vs. 40.36%,
P < 0.001). Utilization of coronary artery bypass grafting (CABG)
was lower in patients with psychosis (8.01% vs. 9.18%, P < 0.001).
In-hospital mortality was significantly lower in patients with
psychosis (aOR 0.677; 95% CI 0.630–0.727; P < 0.001) but dis-
charge to specialty care higher (aOR 1.870; 95%CI 1.786–1.958;
P < 0.001). In addition, median length of hospitalization (3.77
vs. 2.90 days; P < 0.001) was higher in hospitalizations with
psychosis.
Conclusions Our study displayed increasing proportion of
patients with psychosis admitted due to AMI in last decade
with lower mortality but higher morbidity post-infarction, and
significantly less utilization of PCI and CABG. There was also
increased length of stay patients with MDD. There is need to
explore reasons behind this disparity in outcomes and PCI and
CABG utilization to improve post-AMI outcomes in this vulnerable
population.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.