Department of Mood & Anxiety, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, Singapore 539747, Singapore.
Schizophr Res. 2023 Nov;261:139-144. doi: 10.1016/j.schres.2023.09.022. Epub 2023 Sep 16.
There is limited literature examining the effect of early electroconvulsive therapy(ECT) on the length of stay(LOS), especially for psychotic disorders. This study aimed to evaluate the association between early ECT and LOS in three main groups of patients with bipolar, depressive and primary psychotic disorders.
A retrospective descriptive analysis of 464 patients who received inpatient ECT from May 2017 to March 2021 in a large tertiary psychiatric institution was conducted. Early ECT was defined as ECT done before the mean number of days from admission to initiation of ECT by diagnosis. The main outcome measure was LOS, which was examined by diagnosis between the early and late ECT groups, using a linear regression model with adjustment factors chosen based on univariate analysis.
A strong, significant association was found between early ECT and a shorter LOS (β -28.3, 95 % CI -33.6 to -23.0, p < 0.001), even after accounting for adjustment factors. This association was consistent in all three diagnosis groups: bipolar disorders (β -14.5, 95 % CI -20.1 to -9.0, p < 0.001), major depressive disorder (β -18.2, 95 % CI -27.1 to -9.3, p < 0.001) and psychotic disorders (β -39.0, 95 % CI -46.8 to -31.2, p < 0.001). There was no significant difference in the 30-day readmission rates between the early and late ECT groups trans-diagnostically.
Early ECT is strongly associated with a shorter LOS across a range of diagnostic indications including major depressive disorder, bipolar disorder and schizophrenia. ECT can be considered earlier in treatment-decision algorithms and may offer a reduction in LOS.
关于早期电抽搐治疗（ECT）对住院时间（LOS）的影响，文献资料有限，特别是针对精神病性障碍。本研究旨在评估早期 ECT 与三种主要的双相障碍、抑郁障碍和原发性精神病性障碍患者群体 LOS 之间的关联。
对一家大型三级精神病院 2017 年 5 月至 2021 年 3 月期间收治的 464 例接受住院 ECT 的患者进行回顾性描述性分析。早期 ECT 定义为ECT 开始时间与根据诊断确定的入院至 ECT 开始的平均天数之前进行的 ECT。主要结局指标为 LOS，通过诊断对早期和晚期 ECT 组之间的 LOS 进行检查，使用线性回归模型，并根据单变量分析选择调整因素。
即使在考虑了调整因素后，早期 ECT 与 LOS 缩短之间仍存在很强的显著关联（β -28.3，95%CI -33.6 至 -23.0，p<0.001）。这种关联在所有三种诊断组中均一致：双相障碍（β -14.5，95%CI -20.1 至 -9.0，p<0.001）、重度抑郁障碍（β -18.2，95%CI -27.1 至 -9.3，p<0.001）和精神病性障碍（β -39.0，95%CI -46.8 至 -31.2，p<0.001）。在跨诊断的早期和晚期 ECT 组之间，30 天再入院率没有显著差异。
早期 ECT 与一系列诊断指标包括重度抑郁障碍、双相障碍和精神分裂症的 LOS 缩短密切相关。在治疗决策算法中可以更早考虑 ECT，并且可能会降低 LOS。
