Scholarlink

Background <p>Although comorbid medical diseases are important determinants of outcome among the critically ill, the role of psychiatric comorbidity is not well defined. The objective of this study was to determine the occurrence of psychiatric comorbidity and its effect on the outcome of patients admitted to adult intensive care units (ICU) in Queensland.</p> Methods <p>Admissions among adults to 12 ICUs in Queensland during 2015–2021 were included and clinical and outcome information was obtained through linkages between the ANZICS Adult Patient Database, the state-wide Queensland Hospital Admitted Patient Data Collection, and death registry.</p> Results <p>A total of 89,123 admissions were included among 74,513 individuals. Overall, 7,178 (8.1%) admissions had psychiatric co-morbidity with 6,270 (7.0%) having one major psychiatric diagnosis and 908 (1%) having two or more. Individual diagnoses of mood, psychotic, anxiety, or affective disorders were present in 1,801 (2.0%), 874 (1.0%), 3,241 (3.6%) and 354 (0.4%) admissions respectively. Significant differences were observed among the main groups (mood, affective, anxiety, psychotic, or multiple&#xa0;disorders) and those without psychiatric comorbidity with respect to main diagnosis, Acute Physiology and Chronic Health Evaluation (APACHE II) score, sex, age, and medical comorbidity. Crude 30-day case-fatality rates were significantly lower (5.1%) compared to the general ICU population (10.1%) (<i>p</i> &lt; 0.001). After controlling for confounding variables in the logistic regression model, patients with psychiatric comorbidity were at lower odds of death.</p> Conclusions <p>Psychiatric comorbidity is common among ICU presentations and is associated with a lower risk of death. This association is likely to be more complex than being a simple protective factor, and future research needs to further delineate how psychiatric comorbidity informs outcomes of specific ICU presentations.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Major psychiatric comorbidity among the critically ill: a multi-centred cohort study in Queensland

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年2月12日

查看全文
  • Dylan Flaws,
  • Kyle White,
  • Felicity Edwards,
  • Stuart Baker,
  • Siva Senthuran,
  • Mahesh Ramanan,
  • Antony G Attokaran,
  • Aashish Kumar,
  • James McCullough,
  • Kiran Shekar,
  • Philippa McIlroy,
  • Alexis Tabah,
  • Stephen Luke,
  • Peter Garrett,
  • Kevin B Laupland,
  • Kerina J Denny,
  • Mandy Tallott,
  • Andrea Marshall,
  • David Moore,
  • Sunil Sane,
  • Lynette Morrison,
  • Pam Dipplesman,
  • Ahmad Nasser,
  • David Stewart,
  • Vikram Shah,
  • Adam Suliman,
  • Jason Meyer,
  • Ra’eesa Doola,
  • Rod Hurford,
  • Meg Harward,
  • James Walsham,
  • Neeraj Bhadange,
  • Wayne Stevens,
  • Hannah McCabe,
  • Vijo Kuruvilla,
  • Adam Visser,
  • Judy Smith,
  • Tess Evans,
  • Jayesh Dhanani,
  • Pierre Clement,
  • Nermin Karamujic,
  • Jayshree Lavana,
  • George Cornmell,
  • Hamish Pollock,
  • Kylie Jacobs,
  • Prashanti Marella,
  • Jatinder Grewal,
  • Patrick Young,
  • Julia Affleck,
  • Paula Lister,
  • Vikram Masurkar,
  • Lauren Murray,
  • Jane Brailsford,
  • Janine Garrett,
  • Anamika Ganju,
  • Langa Lutshaba,
  • Cameron Anderson,
  • Jaco Poggenpoel,
  • Josephine Reoch,
  • Anni Paasilahti,
  • Jennifer Taylor,
  • Christopher Smart,
  • Stephen Whebell,
  • Sananta Dash,
  • Sebastiaan Blank,
  • Ben Nash,
  • Michelle Gatton,
  • Zephanie Tyack,
  • Sam Keogh

摘要

Background

Although comorbid medical diseases are important determinants of outcome among the critically ill, the role of psychiatric comorbidity is not well defined. The objective of this study was to determine the occurrence of psychiatric comorbidity and its effect on the outcome of patients admitted to adult intensive care units (ICU) in Queensland.

Methods

Admissions among adults to 12 ICUs in Queensland during 2015–2021 were included and clinical and outcome information was obtained through linkages between the ANZICS Adult Patient Database, the state-wide Queensland Hospital Admitted Patient Data Collection, and death registry.

Results

A total of 89,123 admissions were included among 74,513 individuals. Overall, 7,178 (8.1%) admissions had psychiatric co-morbidity with 6,270 (7.0%) having one major psychiatric diagnosis and 908 (1%) having two or more. Individual diagnoses of mood, psychotic, anxiety, or affective disorders were present in 1,801 (2.0%), 874 (1.0%), 3,241 (3.6%) and 354 (0.4%) admissions respectively. Significant differences were observed among the main groups (mood, affective, anxiety, psychotic, or multiple disorders) and those without psychiatric comorbidity with respect to main diagnosis, Acute Physiology and Chronic Health Evaluation (APACHE II) score, sex, age, and medical comorbidity. Crude 30-day case-fatality rates were significantly lower (5.1%) compared to the general ICU population (10.1%) (p < 0.001). After controlling for confounding variables in the logistic regression model, patients with psychiatric comorbidity were at lower odds of death.

Conclusions

Psychiatric comorbidity is common among ICU presentations and is associated with a lower risk of death. This association is likely to be more complex than being a simple protective factor, and future research needs to further delineate how psychiatric comorbidity informs outcomes of specific ICU presentations.