Bipolar disorder and pulmonary embolism: A Portuguese population-based observational retrospective study (2008-2015)

Abstract

Bipolar Disorder (BD) is a chronic mood disorder associated with significant morbidity and a higher mortality rate compared to the general population. Previous studies have shown an association between BD and an increased risk of pulmonary embolism (PE). The aim of this study is to study the correlation between BD and PE in Portuguese patients, and relate it to sociodemographic data, comorbidities and inpatient treatment. We performed an observational retrospective study using a national hospitalization database that gathers all hospitalizations in Portuguese hospitals from 2008-2015. Episodes of BD, PE, and other data were selected using the International Classification of Diseases version 9, Clinical Modification (ICD-9-CM). All hospitalizations with a primary diagnosis of PE were selected using the codes 415.1x. BD was identified based on the codes 296.xx (excluding 296.2x; 296.3x and 296.9x). A total of 22140 hospitalizations with a primary diagnosis of PE were analyzed and among these hospitalizations, 92 had a secondary diagnosis of BD (0.42%). Both groups of patients who experienced a PE event, regardless of the diagnosis of BD, showed a higher prevalence of female patients. The median age at admission for the BD group was significantly lower when compared to the control group, and BD patients had a significantly higher percentage of obesity and tobacco use, which are both known risk factors for PE. This is the first study aimed at correlating BD and PE in Portuguese patients, as there are no similar studies currently available in scientific literature.