Department of Psychological Medicine, South London and Maudsley NHS Foundation Trust, Liaison Psychiatry for Older People, King's College Hospital, London, UK.
Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience (IoPPN), King's College London, London, UK.
Int J Geriatr Psychiatry. 2021 Mar;36(3):423-432. doi: 10.1002/gps.5438. Epub 2020 Oct 5.
To explore the relationship between social and clinical factors with (1) Time to referral to an older adult liaison psychiatry service, and (2) Length of stay (LOS), in a sample of older adults admitted to an acute general medical hospital receiving liaison psychiatry intervention, in London, United Kingdom, over a 3-year period.
Information on patients referred to liaison psychiatry for older adults between January 2013 and December 2015 was collected using structured forms, with clinical diagnoses determined according to International Classification of Mental Disorders-10. The association of social and clinical factors with the time taken to refer to liaison psychiatry and LOS was assessed using Cox proportional hazards regression and zero-truncated Poisson regression, respectively.
Compared with people who were diagnosed with depression, older adults with psychotic and alcohol use disorders had higher rates of referral to liaison psychiatry (adjusted hazard ratios [aHRs] 1.83 [95% CI: 1.30, 2.59] and aHR 1.69 [95% CI: 1.01, 2.83]) respectively. In adjusted models, LOS was increased in older adults with delusional disorders and shorter in people with alcohol use disorders, personality disorders and learning disabilities, compared to people with depressive diagnoses. Within this cohort, a new definite dementia diagnosis and longer time to refer to liaison psychiatry were both associated with a longer length of general hospital in-patient stay.
In older adults admitted to general medical hospitals, and needing liaison psychiatry input, timely referral may be associated with a shorter LOS.
探索社会和临床因素与（1）转介至老年联络精神病学服务的时间，以及（2）在英国伦敦的一家急性综合医院接受联络精神病学干预的老年患者样本中的住院时间（ LOS ）之间的关系，研究时间跨度为 3 年。
通过结构化表格收集了 2013 年 1 月至 2015 年 12 月期间转介至老年联络精神病学的患者信息，临床诊断根据《国际疾病分类-10》确定。使用 Cox 比例风险回归和零截断泊松回归分别评估社会和临床因素与转介至联络精神病学的时间和 LOS 之间的关联。
与被诊断为抑郁症的患者相比，患有精神病和酒精使用障碍的老年患者转介至联络精神病学的比例更高（调整后的危险比[aHR]分别为 1.83[95%CI:1.30,2.59]和 1.69[95%CI:1.01,2.83]）。在调整模型中，与患有抑郁诊断的患者相比，患有妄想障碍的老年患者的 LOS 增加，而患有酒精使用障碍、人格障碍和学习障碍的老年患者的 LOS 则缩短。在该队列中，新的明确痴呆诊断和转介至联络精神病学的时间较长均与综合医院住院时间延长有关。
在被转介至综合医院接受联络精神病学治疗的老年患者中，及时转介可能与 LOS 缩短有关。
