Mathekga Mokgokong, Mdaka Nokhutula, Talatala Mvuyiso
Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand Johannesburg, South Africa.
Department of Psychiatry, Faculty of Health Sciences, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
S Afr J Psychiatr. 2024 Nov 27;30:2329. doi: 10.4102/sajpsychiatry.v30i0.2329. eCollection 2024.
Limited research exists on mortality rates and contributing factors among individuals with severe mental illness (SMI) in long-term psychiatric care, especially in low- and middle-income countries (LMICs).
To analyse mortality rates and associated factors at Solomon Stix Morewa Memorial Hospital (SSMMH), a long-term psychiatric care facility in Johannesburg, South Africa.
SSMMH, a private facility in Selby Park, Johannesburg, has been contracted by the Gauteng Department of Health since March 2017 to provide inpatient care for SMI patients.
A retrospective analysis was conducted on records of 406 SMI patients admitted to SSMMH from March 2017 to February 2022. Mortality rates were calculated, and associated factors were analysed using descriptive statistics and logistic regression.
Of the 406 participants, 34 (8%) died over five years, yielding a standardised mortality ratio (SMR) of 1.28 (95% CI: 0.85-1.71). Mortality was highest in the 60-69 years age group (SMR 2.7), with most deaths occurring in 2020-2021, likely due to COVID-19. Cardiovascular conditions were the leading cause of death (53%). Age at admission (OR: 2.35, 95% CI: 1.55-3.58) and transfer site (OR: 0.58, 95% CI: 0.42-0.81) were significant predictors of mortality.
Individuals with SMI face elevated mortality rates, with age, diagnosis, and comorbidities as key factors.
This study provides insights into the comprehensive management of people with SMI to reduce mortality. Further research is needed to guide psychosocial and palliative care approaches.
关于长期接受精神科护理的严重精神疾病（SMI）患者的死亡率及影响因素的研究有限，尤其是在低收入和中等收入国家（LMICs）。
分析南非约翰内斯堡一家长期精神科护理机构所罗门·斯蒂克斯·莫雷瓦纪念医院（SSMMH）的死亡率及相关因素。
SSMMH是约翰内斯堡塞尔比公园的一家私立机构，自2017年3月起与豪登省卫生部签约，为SMI患者提供住院护理。
对2017年3月至2022年2月入住SSMMH的406例SMI患者的记录进行回顾性分析。计算死亡率，并使用描述性统计和逻辑回归分析相关因素。
在406名参与者中，34人（8%）在五年内死亡，标准化死亡率（SMR）为1.28（95%CI：0.85-1.71）。60-69岁年龄组的死亡率最高（SMR为2.7），大多数死亡发生在2020-2021年，可能是由于新冠疫情。心血管疾病是主要死因（53%）。入院年龄（OR：2.35，95%CI：1.55-3.58）和转诊地点（OR：0.58，95%CI：0.42-0.81）是死亡率的重要预测因素。
SMI患者面临较高的死亡率，年龄、诊断和合并症是关键因素。
本研究为降低SMI患者死亡率的综合管理提供了见解。需要进一步研究以指导心理社会和姑息治疗方法。
