Ismail Zahinoor, Arenovich Tamara, Granger Robert, Grieve Charlotte, Willett Peggie, Patten Scott, Mulsant Benoit H
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Clinical Research Department, Centre for Addiction and Mental Health, Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Int Psychogeriatr. 2015 Feb;27(2):313-321. doi: 10.1017/S1041610214002002.
Geriatric psychiatry hospital beds are a limited resource. Our aim was to determine predictors of hospital length of stay (LOS) for geriatric patients with dementia admitted to inpatient psychiatric beds.
Admission and discharge data from a large urban mental health center, from 2005 to 2010 inclusive, were retrospectively analyzed. Using the resident assessment instrument - mental health (RAI-MH), an assessment that is used to collect demographic and clinical information within 72 hours of hospital admission, 169 geriatric patients with dementia were compared with 308 geriatric patients without dementia. Predictors of hospital LOS were determined using a series of general linear models.
A diagnosis of dementia did not predict a longer LOS in this geriatric psychiatry inpatient population. The presence of multiple medical co-morbidities had an inverse relationship to length of hospital LOS - a greater number of co-morbidities predicted a shorter hospital LOS in the group of geriatric patients who had dementia compared to the without dementia study group. The presence of incapacity and positive psychotic symptoms predicted longer hospital LOS, irrespective of admission group (patients with dementia compared with those without). Conversely, pain on admission predicted shorter hospital LOS.
Specific clinical characteristics generally determined at the time of admission are predictive of hospital LOS in geriatric psychiatry inpatients. Addressing these factors early on during admission and in the community may result in shorter hospital LOS and more optimal use of resources.
老年精神病学病床是一种有限的资源。我们的目的是确定入住精神病住院病床的老年痴呆患者住院时间（LOS）的预测因素。
回顾性分析了一家大型城市心理健康中心2005年至2010年（含）的入院和出院数据。使用居民评估工具 - 心理健康（RAI-MH），该评估用于在入院72小时内收集人口统计学和临床信息，将169名老年痴呆患者与308名无痴呆的老年患者进行比较。使用一系列一般线性模型确定住院LOS的预测因素。
在该老年精神病学住院患者群体中，痴呆诊断并不能预测更长的LOS。多种医疗合并症的存在与住院LOS长度呈负相关 - 与无痴呆研究组相比，更多的合并症预测患有痴呆的老年患者组住院LOS更短。无行为能力和阳性精神病症状的存在预测住院LOS更长，无论入院组如何（痴呆患者与无痴呆患者相比）。相反，入院时的疼痛预测住院LOS更短。
入院时通常确定的特定临床特征可预测老年精神病学住院患者的住院LOS。在入院期间和社区早期解决这些因素可能会缩短住院LOS并更优化资源利用。
