Chin-Kuo Chang, Richard D Hayes, Matthew Broadbent, Hitesh Shetty, Yu-Ping Su, Paul D Meesters, Robert Stewart
{"title":"患有严重精神疾病的老年人面临的身体健康挑战:基于人群的回顾性队列研究。","authors":"Chin-Kuo Chang, Richard D Hayes, Matthew Broadbent, Hitesh Shetty, Yu-Ping Su, Paul D Meesters, Robert Stewart","doi":"10.1192/bjo.2024.765","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Severe mental illness (SMI), which includes schizophrenia, schizoaffective disorder and bipolar disorder, has profound health impacts, even in the elderly.</p><p><strong>Aims: </strong>To evaluate relative risk of hospital admission and length of hospital stay for physical illness in elders with SMI.</p><p><strong>Method: </strong>To construct a population-based retrospective cohort observed from April 2007 to March 2016, data from a case registry with full but de-identified electronic health records were retrieved for patients of the South London and Maudsley NHS Foundation Trust, the single secondary mental healthcare service provider in south-east London. We compared participants with SMI aged >60 years old with the general population of the same age and residing in the same areas through data linkage by age-, sex- and fiscal-year-standardised admission ratios (SARs) for primary diagnoses at hospital discharge. Furthermore, we compared the duration of hospital stay with an age-, sex- and cause-of-admission-matched random group by linear regression for major causes of admission.</p><p><strong>Results: </strong>In total, records for 4175 older people with SMI were obtained, relating to 10 342 admission episodes, showing an overall SAR for all physical illnesses of 5.15 (95% CI: 5.05, 5.25). Among the top causes of admission, SARs ranged from 3.87 for circulatory system disorders (ICD-10 codes: I00-I99) to 6.99 for genitourinary system or urinary conditions (N00-N39). Specifically, the diagnostic group of 'symptoms, signs and findings, not elsewhere classified' (R00-R99) had an elevated SAR of 6.56 (95% CI: 6.22, 6.90). Elders with SMI also had significantly longer hospital stays than their counterparts in the general population, especially for digestive system illnesses (K00-K93), after adjusting for confounding.</p><p><strong>Conclusions: </strong>Poorer overall physical health and specific patterns were identified in elders with SMI.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":null,"pages":null},"PeriodicalIF":3.9000,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536298/pdf/","citationCount":"0","resultStr":"{\"title\":\"Physical health challenges faced by elders with severe mental illness: population-based retrospective cohort study.\",\"authors\":\"Chin-Kuo Chang, Richard D Hayes, Matthew Broadbent, Hitesh Shetty, Yu-Ping Su, Paul D Meesters, Robert Stewart\",\"doi\":\"10.1192/bjo.2024.765\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Severe mental illness (SMI), which includes schizophrenia, schizoaffective disorder and bipolar disorder, has profound health impacts, even in the elderly.</p><p><strong>Aims: </strong>To evaluate relative risk of hospital admission and length of hospital stay for physical illness in elders with SMI.</p><p><strong>Method: </strong>To construct a population-based retrospective cohort observed from April 2007 to March 2016, data from a case registry with full but de-identified electronic health records were retrieved for patients of the South London and Maudsley NHS Foundation Trust, the single secondary mental healthcare service provider in south-east London. We compared participants with SMI aged >60 years old with the general population of the same age and residing in the same areas through data linkage by age-, sex- and fiscal-year-standardised admission ratios (SARs) for primary diagnoses at hospital discharge. Furthermore, we compared the duration of hospital stay with an age-, sex- and cause-of-admission-matched random group by linear regression for major causes of admission.</p><p><strong>Results: </strong>In total, records for 4175 older people with SMI were obtained, relating to 10 342 admission episodes, showing an overall SAR for all physical illnesses of 5.15 (95% CI: 5.05, 5.25). Among the top causes of admission, SARs ranged from 3.87 for circulatory system disorders (ICD-10 codes: I00-I99) to 6.99 for genitourinary system or urinary conditions (N00-N39). Specifically, the diagnostic group of 'symptoms, signs and findings, not elsewhere classified' (R00-R99) had an elevated SAR of 6.56 (95% CI: 6.22, 6.90). Elders with SMI also had significantly longer hospital stays than their counterparts in the general population, especially for digestive system illnesses (K00-K93), after adjusting for confounding.</p><p><strong>Conclusions: </strong>Poorer overall physical health and specific patterns were identified in elders with SMI.</p>\",\"PeriodicalId\":9038,\"journal\":{\"name\":\"BJPsych Open\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536298/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BJPsych Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1192/bjo.2024.765\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJPsych Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1192/bjo.2024.765","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
摘要
背景:严重精神疾病(SMI)包括精神分裂症、精神分裂情感障碍和双相情感障碍,对健康有深远影响,甚至对老年人也是如此。目的:评估患有严重精神疾病的老年人因身体疾病入院的相对风险和住院时间:为了构建一个基于人群的回顾性队列,我们从病例登记处调取了 2007 年 4 月至 2016 年 3 月期间伦敦东南部唯一的二级精神医疗服务提供者--南伦敦和莫兹利 NHS 基金会信托基金会(South London and Maudsley NHS Foundation Trust)患者的完整但去身份化的电子健康记录。我们通过出院时主要诊断的年龄、性别和财政年度标准化入院比率(SARs)进行数据链接,将年龄大于 60 岁的 SMI 患者与居住在同一地区的同龄普通人群进行了比较。此外,我们还通过对主要入院原因的线性回归,将住院时间与年龄、性别和入院原因匹配的随机组进行了比较:结果:我们共获得了 4175 名患有 SMI 的老年人的病历,涉及 10 342 次入院治疗,所有身体疾病的总体 SAR 为 5.15(95% CI:5.05,5.25)。在最主要的入院原因中,SAR 从循环系统疾病(ICD-10 代码:I00-I99)的 3.87 到泌尿生殖系统或泌尿系统疾病(N00-N39)的 6.99 不等。具体来说,"症状、体征和检查结果,未在别处分类"(R00-R99)这一诊断组的 SAR 值为 6.56(95% CI:6.22,6.90)。在对混杂因素进行调整后,患有SMI的老年人的住院时间也明显长于普通人群,尤其是消化系统疾病(K00-K93):结论:患有 SMI 的长者总体身体健康状况较差,且有特定的健康模式。
Physical health challenges faced by elders with severe mental illness: population-based retrospective cohort study.
Background: Severe mental illness (SMI), which includes schizophrenia, schizoaffective disorder and bipolar disorder, has profound health impacts, even in the elderly.
Aims: To evaluate relative risk of hospital admission and length of hospital stay for physical illness in elders with SMI.
Method: To construct a population-based retrospective cohort observed from April 2007 to March 2016, data from a case registry with full but de-identified electronic health records were retrieved for patients of the South London and Maudsley NHS Foundation Trust, the single secondary mental healthcare service provider in south-east London. We compared participants with SMI aged >60 years old with the general population of the same age and residing in the same areas through data linkage by age-, sex- and fiscal-year-standardised admission ratios (SARs) for primary diagnoses at hospital discharge. Furthermore, we compared the duration of hospital stay with an age-, sex- and cause-of-admission-matched random group by linear regression for major causes of admission.
Results: In total, records for 4175 older people with SMI were obtained, relating to 10 342 admission episodes, showing an overall SAR for all physical illnesses of 5.15 (95% CI: 5.05, 5.25). Among the top causes of admission, SARs ranged from 3.87 for circulatory system disorders (ICD-10 codes: I00-I99) to 6.99 for genitourinary system or urinary conditions (N00-N39). Specifically, the diagnostic group of 'symptoms, signs and findings, not elsewhere classified' (R00-R99) had an elevated SAR of 6.56 (95% CI: 6.22, 6.90). Elders with SMI also had significantly longer hospital stays than their counterparts in the general population, especially for digestive system illnesses (K00-K93), after adjusting for confounding.
Conclusions: Poorer overall physical health and specific patterns were identified in elders with SMI.
期刊介绍:
Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.