The impact of comorbid psychiatric disorders on chronic obstructive pulmonary disease (COPD) hospitalizations: a nationwide retrospective study.

IF 3.6 2区医学 Q1 PSYCHIATRY Social Psychiatry and Psychiatric Epidemiology Pub Date : 2024-11-01 Epub Date: 2024-03-01 DOI:10.1007/s00127-024-02645-x

Gonçalo Santos, Ana Rita Ferreira, Manuel Gonçalves-Pinho, Alberto Freitas, Lia Fernandes

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Abstract

Aims: To characterize the register of a secondary diagnosis of mental illnesses in all chronic obstructive pulmonary disease (COPD) hospitalizations registered in Portugal from 2008 to 2015 and explore their impact on hospitalization outcomes.

Methods: A retrospective observational study was conducted. Hospitalizations of patients with at least 40 years old, discharged between 2008 and 2015 with a primary diagnosis of COPD (ICD-9-CM codes 491.x, 492.x and 496) were retrieved from a national administrative database. Comorbid psychiatric diagnoses were identified and defined by the HCUP Clinical Classification Software (CCS) category codes 650-670 (excluding 662). Length of hospital stay (LoS), admission type, in-hospital mortality, and estimated hospital charges were analyzed according to psychiatric diagnostic categories using sex and age-adjusted models.

Results: Of 66,661 COPD hospitalizations, 25,869 (38.8%) were episodes with a registered psychiatric comorbidity. These were more likely to correspond to younger inpatients (OR = 2.16, 95%CI 2.09-2.23; p < 0.001), to stay longer at the hospital (aOR = 1.08, 95%CI 1.05-1.12; p < 0.001), to incur in higher estimated hospital charges (aOR = 1.37, 95%CI 1.33-1.42; p < 0.001) and to be urgently admitted (aOR = 1.33, 95%CI 1.23-1.44; p < 0.001). After adjustment for age, in-hospital mortality was lower for episodes with psychiatric diagnoses (aOR = 0.90; 95%CI 0.84-0.96; p < 0.001), except for organic and neurodegenerative diseases category and developmental disorders, intellectual disabilities and disorders usually diagnosed in infancy, childhood, or adolescence category.

Discussion: These findings corroborate the additional burden placed by psychiatric disorders on COPD hospitalizations, highlighting the importance of individualizing care to address these comorbidities and minimize their impact on treatment outcomes.

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合并精神障碍对慢性阻塞性肺病（COPD）住院治疗的影响：一项全国范围的回顾性研究。

目的：分析2008年至2015年葡萄牙登记的所有慢性阻塞性肺病（COPD）住院病例中精神疾病二次诊断的登记情况，并探讨其对住院治疗结果的影响：方法：开展了一项回顾性观察研究。从国家行政数据库中检索了 2008 年至 2015 年期间出院的至少 40 岁、主要诊断为慢性阻塞性肺病（ICD-9-CM 代码 491.x、492.x 和 496）的住院患者。合并精神病诊断由 HCUP 临床分类软件 (CCS) 类别代码 650-670 （不包括 662）确定和定义。采用性别和年龄调整模型，根据精神病诊断类别对住院时间（LoS）、入院类型、院内死亡率和估计住院费用进行了分析：在 66,661 例慢性阻塞性肺病住院患者中，有 25,869 例（38.8%）登记有精神病合并症。这些患者更有可能是年轻的住院病人（OR = 2.16，95%CI 2.09-2.23；P 讨论）：这些研究结果证实了精神疾病给慢性阻塞性肺病住院患者带来的额外负担，强调了个性化护理的重要性，以解决这些合并症并最大限度地减少其对治疗结果的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Social Psychiatry and Psychiatric Epidemiology 医学-精神病学

CiteScore

8.50

自引率

2.30%

发文量

184

审稿时长

3-6 weeks

期刊介绍： Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic. In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation. Both original work and review articles may be submitted.