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转介至会诊-联络精神科服务的住院患者临床概况:一项评估10年期间变化的观察性研究

Clinical profile of inpatients referred to a consultation-liaison psychiatry service: an observational study assessing changes over a 10-yearperiod.

作者信息

Sánchez-González Roberto, Baillès-Lázaro Eva, Bastidas-Salvadó Anna, Lligoña Anna, Herranz-Villanueva Sandra, Pérez-Solá Víctor, Pintor-Pérez Luis

机构信息

Department of Psychiatry. Institut de Neuropsiquiatria i Addiccions. Hospital del Mar. Barcelona. Spain IMIM (Hospital del Mar Medical Research Institute). Barcelona. Spain.

Consultation-Liaison Service. Department of Psychiatry. Institut de Neurociències. Hospital Clínic i Provincial de Barcelona. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Universitat de Barcelona. CERCA Programme/Generalitat de Catalunya. Barcelona. Spain.

出版信息

Actas Esp Psiquiatr. 2018 Mar;46(2):58-67. Epub 2018 Mar 1.

Abstract

OBJECTIVE

Previous research has described the characteristics of Consultation-liaison psychiatry (CLP) services over one or more years. The aim of this paper was to examine the patterns of a large sample of patients receiving CLP service over a 10-year-period (2005–2014) and to determine the possible changes over time of the clinical practice. The sample size of our study, the duration of the observation period and the application of standardized operating procedures for acquiring and coding data, will provide more robust evidence than has been reported by most similar studies published in the last years.

METHODS

Longitudinal observational and descriptive study. Data were collected prospectively with standardized operating procedures on consecutive inpatient consultation requests to the University Clinical Hospital of Barcelona CLP service.

RESULTS

9,808 psychiatric consultation were requested (referral rate=2.2%). The referrals to our CLP service were requested mainly by medical units. The most frequent psychiatric diagnoses were alcohol-related disorders, delirium and adjustment disorders. The mean percentage of patients treated with psychopharmacologic drugs was 81.6%. The mean length of the hospital stays of patients with psychiatric comorbidity referred to our CLP service was significantly longer than that of all the admissions to the hospital during that period. Most of the studied variables remained constant over the 10-year-period. However, some somatic diagnoses at admission, reasons for referral and recommendations of psychotropic drugs presented significant changes.

CONCLUSIONS

Despite the continuous evolution and changes of several factors in the last two decades, like the health care systems, the clinical practice of CLP services has been quite stable over time. However, our results support the idea of a non-static specialty.

摘要

目的

以往研究描述了会诊联络精神病学(CLP)服务在一年或多年中的特征。本文旨在研究一大样本患者在10年期间(2005 - 2014年)接受CLP服务的模式,并确定临床实践随时间可能发生的变化。我们研究的样本量、观察期的持续时间以及获取和编码数据的标准化操作程序,将提供比过去几年发表的大多数类似研究更有力的证据。

方法

纵向观察性和描述性研究。采用标准化操作程序前瞻性收集巴塞罗那大学临床医院CLP服务连续住院会诊请求的数据。

结果

共收到9808次精神科会诊请求(转诊率 = 2.2%)。转至我们CLP服务的请求主要来自医疗科室。最常见的精神科诊断为酒精相关障碍、谵妄和适应障碍。接受精神药物治疗的患者平均比例为81.6%。转至我们CLP服务的合并精神疾病患者的平均住院时间显著长于该时期医院所有入院患者的平均住院时间。在这10年期间,大多数研究变量保持不变。然而,入院时的一些躯体诊断、转诊原因和精神药物推荐出现了显著变化。

结论

尽管在过去二十年中,医疗保健系统等几个因素不断演变和变化,但CLP服务的临床实践随着时间推移一直相当稳定。然而,我们的结果支持该专业并非一成不变的观点。

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