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人格障碍诊断人群中与再次入院相关的因素

Factors Associated with Hospital Readmission in a Population with a Diagnosis of Personality Disorder.

作者信息

Carbonel-Aranda Vera, González Ariadna, García-Illanes Yaiza, Traverso-Rodríguez María, Bordallo-Aragón Antonio, Goodman-Casanova Jessica Marian, Guzman-Parra Jose

机构信息

Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain; Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Málaga, Andalucía Tech, Campus de Teatinos S/N, 29071 Malaga, Spain.

Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Malaga, Spain.

出版信息

Actas Esp Psiquiatr. 2024 Dec;52(6):750-758. doi: 10.62641/aep.v52i6.1796.

Abstract

BACKGROUND

Hospital readmissions of users with personality disorders are frequent and represent a high personal and economic cost for health systems. This study aimed to identify risk factors associated with readmission in this population, examining sociodemographic and clinical variables.

METHODS

A retrospective observational study was conducted, using electronic records. The study was carried out at the Mental Health Hospitalization Unit of the Regional University Hospital of Málaga, covering all admissions between January 1, 2007, and March 31, 2024. Patients with a primary or secondary International Classification of Diseases, 10th Edition (ICD-10) personality disorder diagnosis were included. The dependent variable was hospital readmission, analyzed both at 30 days and at 1 year. Mixed logistic regression models were used to identify risk factors.

RESULTS

A total of 2403 admissions of 1072 individuals for 30-day readmission and 2256 admissions of 1029 individuals for 1-year readmission were analyzed; 17.15% of the admissions resulted in readmission at 30 days, and 42.33% at 1 year. The variables significantly associated with early readmission in the multivariate analysis were younger age (odds ratio (OR) = 0.973, p < 0.001), having a history of previous admissions (OR = 1.900, p < 0.001), and voluntary admission (OR = 1.348, p = 0.033). For readmission at 1 year, the significant variables included younger age (OR = 0.973, p < 0.001), history of previous admissions (OR = 1.956, p < 0.001), having another type of personality disorder diagnosis other than emotionally unstable personality disorder (OR = 0.654, p = 0.006), and comorbidity with affective (OR = 1.726, p = 0.025) and anxiety (OR = 1.915, p = 0.034) disorders compared to no comorbidity.

CONCLUSIONS

This study identified key risk factors for hospital readmission of individuals with personality disorders, including younger age, previous admissions, voluntary admission, specific personality disorder types, and comorbidity with affective and anxiety disorders. These findings underscore the need for future research to better understand the risk factors for readmission in this population.

摘要

背景

人格障碍患者的医院再入院情况频繁,对卫生系统而言意味着高昂的个人和经济成本。本研究旨在确定该人群中与再入院相关的风险因素,研究社会人口学和临床变量。

方法

采用电子记录进行回顾性观察研究。研究在马拉加地区大学医院的精神科住院部开展,涵盖2007年1月1日至2024年3月31日期间的所有入院病例。纳入主要或次要诊断为国际疾病分类第10版(ICD - 10)人格障碍的患者。因变量为医院再入院情况,分别在30天和1年时进行分析。使用混合逻辑回归模型确定风险因素。

结果

共分析了1072例患者的2403次30天再入院情况以及1029例患者的2256次1年再入院情况;17.15%的入院病例在30天内导致再入院,1年时为42.33%。多变量分析中与早期再入院显著相关的变量包括年龄较小(比值比(OR)=0.973,p<0.001)、有既往入院史(OR = 1.900,p<0.001)和自愿入院(OR = 1.348,p = 0.033)。对于1年时的再入院情况,显著变量包括年龄较小(OR = 0.973,p<0.001)、既往入院史(OR = 1.956,p<0.001)、除情绪不稳定型人格障碍外还有其他类型人格障碍诊断(OR = 0.654,p = 0.006),以及与无合并症相比,合并情感障碍(OR = 1.726,p = 0.025)和焦虑障碍(OR = 1.915,p = 0.034)。

结论

本研究确定了人格障碍患者医院再入院的关键风险因素,包括年龄较小、既往入院、自愿入院、特定人格障碍类型以及合并情感和焦虑障碍。这些发现强调了未来研究需要更好地了解该人群再入院的风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2a6/11636539/0ba5af2157da/ActEsp-52-6-750-758-F1.jpg

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