ArticleBMJ open2021
Stroke care and case fatality in people with and without schizophrenia: a retrospective cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Strengthening the delivery of integrated physical health care for adults experiencing serious mental illness: a scoping review of interventions in mental health settings.Frontiers in health services · 2025Pooled it
- Impact of Schizophrenia on Inpatient Outcomes for Acute Ischemic Stroke: Evidence From the 2005-2020 United States Nationwide Inpatient Sample.Journal of clinical neurology (Seoul, Korea) · 2026Article
- Secondary Stroke Prevention in People With Schizophrenia.Journal of the American Heart Association · 2024Article
- Advanced imaging use and delays among inpatients with psychiatric comorbidity.Brain and behavior · 2024Article
- Association between preferred language and use of mental health services among home care recipients with schizophrenia spectrum and other psychotic disorders: A retrospective cohort study in Ontario, Canada, 2010 to 2015.PLOS mental health · 2024Article
- Exploring the Association between Schizophrenia and Cardiovascular Diseases: Insights into the Role of Sigma 1 Receptor.Physiological research · 2023Review
- Inter-relationships of risk factors and pathways associated with all-cause mortality in patients with chronic schizophrenia.Frontiers in psychiatry · 2023Article
- Mortality in people with schizophrenia: a systematic review and meta-analysis of relative risk and aggravating or attenuating factors.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2022Article
- Schizophrenia and Hospital Admissions for Cardiovascular Events in a Large Population: The APNA Study.Journal of cardiovascular development and disease · 2022Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSchizophrenia is associated with an increased risk of death following stroke; however, the magnitude and underlying reasons for this are not well understood.
objectiveTo determine the association between schizophrenia and stroke case fatality, adjusting for baseline characteristics, stroke severity and processes of care.
designRetrospective cohort study used linked clinical and administrative databases.
settingAll acute care institutions (N=152) in the province of Ontario, Canada.
participantsAll patients (N=52 473) hospitalised with stroke between 1 April 2002 and 31 March 2013 and included in the Ontario Stroke Registry. Those with schizophrenia (n=612) were identified using validated algorithms. MAIN OUTCOMES AND MEASURES: We compared acute stroke care in those with and without schizophrenia and used Cox proportional hazards models to examine the association between schizophrenia and mortality, adjusting for demographics, comorbidity, stroke severity and processes of care.
resultsCompared with those without schizophrenia, people with schizophrenia were less likely to undergo thrombolysis (10.1% vs 13.4%), carotid imaging (66.3% vs 74.0%), rehabilitation (36.6% vs 46.6% among those with disability at discharge) or be treated with antihypertensive, lipid-lowering or anticoagulant therapies. After adjustment for age and other factors, schizophrenia was associated with death from any cause at 1 year (adjusted HR (aHR) 1.33, 95% CI 1.14 to 1.54). This was mainly attributable to early deaths from stroke (aHR 1.47, 95% CI 1.20 to 1.80, with survival curves separating in the first 30 days), and the survival disadvantage was particularly marked in those aged over 70 years (1-year mortality 46.9% vs 35.0%).
conclusionsSchizophrenia is associated with increased stroke case fatality, which is not fully explained by stroke severity, measurable comorbid conditions or processes of care. Future work should focus on understanding this mortality gap and on improving acute stroke and secondary preventive care in people with schizophrenia.
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