Park Jennifer M, Park Lawrence T, Siefert Caleb J, Abraham Melissa E, Fry Christine R, Silvert Mark S
Massachusetts General Hospital, Freedom Trail Clinic, Boston, MA, USA.
J Behav Health Serv Res. 2009 Jul;36(3):300-8. doi: 10.1007/s11414-008-9160-0. Epub 2008 Dec 17.
This study assessed factors associated with extended length of stay (ELOS) for patients presenting to a psychiatric emergency service (PES). Two hundred six subjects with a length of stay of 24 h or longer were compared with time-matched controls (patients that presented directly after the ELOS patient). Binary logistic regression was used to identify risk factors for ELOS. ELOS was associated with suicidal ideation, disposition to an inpatient unit, homicidal ideation, lack of insurance, homelessness, male gender, past history of psychiatric hospitalization, diagnosis of substance abuse, significant psychiatric co-morbidity (represented by three or more Axis I diagnoses), and diagnosis of a psychotic disorder. Lack of insurance, suicidal ideation, disposition to inpatient unit, and homicidal ideation all made nonredundant contributions to predicting stays of 24 h or longer.
本研究评估了与精神科急诊服务（PES）患者延长住院时间（ELOS）相关的因素。将206名住院时间为24小时或更长时间的受试者与时间匹配的对照组（ELOS患者之后直接就诊的患者）进行比较。采用二元逻辑回归来确定ELOS的危险因素。ELOS与自杀意念、入住住院部、杀人意念、缺乏保险、无家可归、男性、既往精神科住院史、药物滥用诊断、严重精神共病（以三个或更多轴I诊断表示）以及精神障碍诊断有关。缺乏保险、自杀意念、入住住院部和杀人意念在预测24小时或更长时间的住院方面均做出了非冗余贡献。
