代谢综合征及其组分与精神病院住院时长相关：来自瑞士精神病队列及首发精神病患者的结果
Metabolic syndrome and its components are associated with lengths of stay in a psychiatric hospital: Results from a Swiss psychiatric cohort and first-episode psychosis patients.
作者信息
Laaboub Nermine, Ranjbar Setareh, Crettol Séverine, Ansermot Nicolas, Vandenberghe Frederik, Grandjean Carole, Piras Marianna, Elowe Julien, Preisig Martin, Gunten Armin Von, Conus Philippe, Eap Chin Bin
机构信息
Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, https://ror.org/05a353079Lausanne University Hospital, University of Lausanne, Prilly, Switzerland.
Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, https://ror.org/05a353079Lausanne University Hospital, University of Lausanne, Prilly, Switzerland.
出版信息
Eur Psychiatry. 2025 May 26;68(1):e65. doi: 10.1192/j.eurpsy.2025.10036.
BACKGROUND
Due to limited inpatient care resources and high healthcare expenditures, understanding factors that affect lengths of stay (LOS) is highly relevant. We aimed to investigate associations between metabolic disturbances and LOS in a psychiatric hospital and to identify other clinical and sociodemographic LOS predictors.
METHODS
Patients admitted to one of the units of the general psychiatric or psychogeriatric departments between January 1, 2007 and December 31, 2020, were included. Metabolic disturbances (i.e., the metabolic syndrome and its five components) were defined using the International Diabetes Federation definition. Cox frailty regression models with time-varying coefficients were used to investigate the association between metabolic disturbances and LOS. Hazard ratios (HR) >1 and HR < 1 indicated the relative likelihood of shorter and extended LOS, respectively.
RESULTS
A total of 7,771 patients for 16,959 hospital stays throughout 14 years of follow-up were included. Central obesity (HR = 0.82; 95% confidence interval [CI] = [0.76-0.89]), hyperglycemia (HR = 0.83; 95% CI = [0.78-0.89]), hypertriglyceridemia (HR = 0.87; 95% CI = [0.80-0.92]), and the metabolic syndrome (HR = 0.76; 95% CI = [0.70-0.82]) were associated with an increased risk of extended LOS in the psychiatric hospital, while underweight (HR = 1.30, 95% CI = [1.09-1.56]) and HDL hypocholesterolemia (HR = 1.10, 95% CI = [1.03-1.18]) were associated with a higher likelihood of shorter LOS. In first-episode psychosis patients, hypertriglyceridemia (HR = 0.82; 95% CI = [0.67-0.99]) and hypertension (HR = 0.76, 95% CI = [0.58-0.99]) were associated with extended LOS when considering all stays, while no association was found when considering the first stay per patient.
CONCLUSION
Future studies should determine whether better metabolic monitoring and treatment of metabolic disturbances can contribute to reducing LOS.
背景
由于住院护理资源有限且医疗费用高昂，了解影响住院时间（LOS）的因素具有高度相关性。我们旨在调查一家精神病医院中代谢紊乱与住院时间之间的关联，并确定其他临床和社会人口学方面的住院时间预测因素。
方法
纳入2007年1月1日至2020年12月31日期间入住普通精神科或老年精神科某一科室的患者。代谢紊乱（即代谢综合征及其五个组成部分）采用国际糖尿病联盟的定义。使用具有时变系数的Cox脆弱回归模型来研究代谢紊乱与住院时间之间的关联。风险比（HR）>1和HR<1分别表示住院时间缩短和延长的相对可能性。
结果
在14年的随访期间，共纳入7771例患者的16959次住院。中心性肥胖（HR = 0.82；95%置信区间[CI]=[0.76 - 0.89]）、高血糖（HR = 0.83；95% CI = [0.78 - 0.89]）、高甘油三酯血症（HR = 0.87；95% CI = [0.80 - 0.92]）和代谢综合征（HR = 0.76；95% CI = [0.70 - 0.82]）与精神病医院住院时间延长的风险增加相关，而体重过轻（HR = 1.30，95% CI = [1.09 - 1.56]）和高密度脂蛋白低胆固醇血症（HR = 1.10，95% CI = [1.03 - 1.18]）与住院时间缩短的可能性较高相关。在首发精神病患者中，考虑所有住院时，高甘油三酯血症（HR = 0.82；95% CI = [0.67 - 0.99]）和高血压（HR = 0.76，95% CI = [0.58 - 0.99]）与住院时间延长相关，而考虑每位患者的首次住院时未发现关联。
结论
未来的研究应确定更好的代谢监测和代谢紊乱治疗是否有助于缩短住院时间。
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