Division of Psychiatry, Haukeland University Hospital, Pb 23, 5812 Bergen, Norway.
Eur Psychiatry. 2012 Oct;27(7):489-95. doi: 10.1016/j.eurpsy.2011.04.002.
Evidence based treatment of schizophrenia as well as antipsychotic drug utility patterns have changed considerably in recent years and the present study aims to investigate the current level of unplanned hospital readmissions in a cohort of patients with schizophrenia, and to determine the risk-reducing effects of current antipsychotic drug treatment.
An open cohort study included all consecutively discharged patients with schizophrenia in a 3-year period (n=277). The treatment-dependent variables were entered in a multivariate Cox survival analyses with time to unplanned readmission as the dependent variable.
11.2% of patients were readmitted within 30 days of discharge, and 44.8% were readmitted within 12 months. Antipsychotic monotherapy reduced the risk of readmission by 74.9%. Treatment in CMHC also had a risk-reducing effect. The prescription rate of clozapine in this sample was 10.1%.
The over-all level of unplanned readmissions was in correspondence with the findings of others. Current antipsychotic drug treatment independently offers strong protection against unplanned readmissions. There may be a potential for further optimalizing antipsychotic drug treatment according to treatment guidelines.
Unplanned readmissions are very common for patients with schizophrenia but antipsychotic drug treatment is associated with a strong risk-reducing effect in this regard.
近年来，精神分裂症的循证治疗和抗精神病药物的应用模式发生了很大变化，本研究旨在调查一组精神分裂症患者目前非计划性住院再入院的水平，并确定当前抗精神病药物治疗的降低风险效果。
一项开放队列研究纳入了 3 年内连续出院的所有精神分裂症患者（n=277）。将治疗相关变量作为因变量，输入到多变量 Cox 生存分析中，以预测非计划性再入院的时间。
11.2%的患者在出院后 30 天内再次入院，44.8%的患者在 12 个月内再次入院。抗精神病药物单药治疗可使再入院风险降低 74.9%。在 CMHC 中的治疗也具有降低风险的效果。本样本中氯氮平的处方率为 10.1%。
总体非计划性再入院水平与其他研究的结果相符。当前的抗精神病药物治疗独立地提供了对非计划性再入院的强大保护作用。根据治疗指南，可能有进一步优化抗精神病药物治疗的潜力。
精神分裂症患者的非计划性再入院非常常见，但抗精神病药物治疗在这方面具有很强的降低风险作用。
