The impact of psychiatric comorbidities on the length of hospital stay in patients with heart failure

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• 作者：Paul Carter^a ; Jennifer Reynolds^b ; Andrew Carter^c ; Siri Potluri^d ; Hardeep Uppal^e ; Suresh Chandran^f ; Rahul Potluri^e ; ^{rahulpotluri@outlook.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Heart failure ; Length of hospital stay ; Psychiatric comorbidities
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 March 2016
• 年：2016
• 卷：207
• 期：Complete
• 页码：292-296
• 全文大小：299 K

文摘

Heart failure (HF) is a major healthcare problem contributing significantly to hospital admission stays and National Health Service (NHS) spending. Reducing length of hospital stay (LoS) in HF is paramount in reducing this burden and is influenced by factors relating to the condition, sociodemographics and comorbidities. Psychiatric comorbidities are being increasingly identified amongst HF patients but their impact on LoS has not been studied in the UK.

Methods

We investigated the impact of psychiatric comorbidities on LoS amongst 31,760 HF patients admitted to hospitals in North England between 1st January 2000 and 31st March 2013 from the ACALM (Algorithm for Comorbidities, Associations, Length of stay and Mortality) study. The ACALM protocol uses ICD-10 and OPCS-4 coding to trace HF patients, psychiatric comorbidities and demographics including LoS.

Results

Amongst 31,760 HF patients mean LoS in the absence of psychiatric comorbidities was 11.2 days. The presence of a psychiatric comorbidity increased LoS by 3.3 days. Logistic regression accounting for age, gender and ethnicity showed that LoS was significantly longer in patients suffering from depression (3.4 days, p < 0.001), bipolar disorder (8.8 days, p < 0.001) and all types of dementia (4.2 days, p < 0.001).

Conclusions

Our results demonstrate that psychiatric comorbidities have a significant and clinically important impact on LoS in HF patients in the UK. Clinicians should be actively aware of psychiatric conditions amongst HF patients and manage them to reduce LoS and ultimately the risk for patients and financial burden for the NHS.