Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Can J Psychiatry. 2012 Nov;57(11):696-703. doi: 10.1177/070674371205701107.
To determine predictors of hospital length of stay (LOS) for adult and geriatric patients with mood disorders admitted to inpatient psychiatric beds.
Admission and discharge data from a large urban mental health centre, from 2005 to 2010 inclusive, were retrospectively analyzed. Using the Resident Assessment Instrument-Mental Health, an assessment that is used to collect demographic and clinical information within 72 hours of hospital admission, 199 geriatric mood disorder admissions were compared with 570 adult mood disorder admissions. Predictors of hospital LOS were determined using a series of general linear models.
Living alone, number of recent psychiatric admissions, involuntary admission, and close or constant observation level predict longer hospital LOS in geriatric, but not in adult mood disorder, patients. Conversely, pain on admission predicts shorter hospital LOS in geriatric, but not among adult, mood disorder patients. Predictors of longer hospital LOS, irrespective of admission group (adult, compared with geriatric), include incapacity, negative symptoms, and increased dependence for instrumental activities of daily living.
Addressing these predictive factors early on during admission and in the community may result in shorter hospital LOS and more optimal use of resources.
确定成年和老年心境障碍患者住院时间（LOS）的预测因素，这些患者被收治于精神科住院病床。
对 2005 年至 2010 年期间一家大型城市心理健康中心的入院和出院数据进行回顾性分析。采用住院病人评估工具-心理健康评估，在入院后 72 小时内收集人口统计学和临床信息，将 199 例老年心境障碍入院患者与 570 例成年心境障碍入院患者进行比较。使用一系列线性回归模型确定 LOS 的预测因素。
独居、近期精神科入院次数、非自愿入院和密切或持续观察水平预测老年心境障碍患者住院 LOS 延长，而成年心境障碍患者则不然。相反，入院时的疼痛预示着老年心境障碍患者的住院 LOS 缩短，但成年心境障碍患者则不然。不论入院人群（成年患者与老年患者），住院 LOS 延长的预测因素包括：丧失能力、阴性症状和日常生活活动工具性依赖程度增加。
在入院期间和社区中尽早解决这些预测因素，可能会导致住院 LOS 缩短和更优化地利用资源。
