Lampros A, Montardi C, Journeau L, Georgin-Lavialle S, Hanslik T, Dhôte R, Goujard C, Le Jeunne C, Mahe I, Papo T, Godeau B, Bourgarit A, Fain O, Fantin B, Dzierzynski N, Leblanc J, Nevoret C, Steichen O
Médecine interne, hôpital Tenon, Sorbonne université, AP-HP, 4, rue de la Chine, 75020 Paris, France.
Médecine interne, hôpital Ambroise-Paré, AP-HP, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt, France.
Rev Med Interne. 2020 Jun;41(6):360-367. doi: 10.1016/j.revmed.2019.12.016. Epub 2020 Jan 22.
Patients with psychiatric disorders suffer from a higher rate of somatic disorders than those without psychiatric disorder, often inappropriately managed. Our study aimed to describe patients with psychiatric comorbidity in post-emergency internal medicine units and to compare their length of hospital stay to patients without psychiatric disease.
This French cross sectional study used the data warehouse of the greater Paris hospitals. It included, all patients hospitalized through the emergency department in 9 internal medicine departments during the year 2017. Psychiatric disorders and the burden of somatic disorders (Charlson score) were determined through diagnostic coding. Charlson score and hospital length of stay were compared between patients with and without psychiatric comorbidity.
In total, 8981 hospital stays (8001 patients) were included, 1867 (21%) with psychiatric comorbidity. After adjusting for age, gender, hospital and main diagnosis, the Charlson score was on average 0.68 higher in the psychiatric comorbidity group (P<0.001) and the length of hospital stay was 30% higher after further adjustment on the Charlson score (P<0.001). These differences were consistent for each main diagnosis.
Patients with psychiatric comorbidity are frequent in post-emergency internal medicine wards. They experience longer hospital stays, only partly related with a higher burden of somatic disorders. Special attention should be paid to this vulnerable population.
患有精神疾病的患者比没有精神疾病的患者患躯体疾病的几率更高,且往往治疗不当。我们的研究旨在描述急诊后内科病房中患有精神疾病合并症的患者,并将他们的住院时间与没有精神疾病的患者进行比较。
这项法国横断面研究使用了大巴黎地区医院的数据仓库。它纳入了2017年期间在9个内科科室通过急诊科住院的所有患者。通过诊断编码确定精神疾病和躯体疾病负担(查尔森评分)。比较了有和没有精神疾病合并症患者的查尔森评分和住院时间。
总共纳入了8981次住院(8001名患者),其中1867次(21%)患有精神疾病合并症。在对年龄、性别、医院和主要诊断进行调整后,精神疾病合并症组的查尔森评分平均高出0.68(P<0.001),在对查尔森评分进一步调整后,住院时间长30%(P<0.001)。这些差异在每种主要诊断中都是一致的。
精神疾病合并症患者在急诊后内科病房中很常见。他们的住院时间更长,这仅部分与更高的躯体疾病负担有关。应特别关注这一弱势群体。