Predictors of hospital admission for patients presenting with psychiatric emergencies: A retrospective, cohort study. (August 2020)

• Record Type: Journal Article
• Authors: Bahji, Anees; Altomare, Josephine; Sapru, Amer; Haze, Spencer; Prasad, Samir; Egan, Rylan
• Is Part Of: Psychiatry research. Volume 290(2020)
• Publication Date: 2020-08
• Subjects: Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2020.113149
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: Rising psychiatric visits represent a significant and growing burden for emergency departments (EDs) across Canada. A variety of clinical and demographic variables increased the risk of hospital admissions for individuals with a variety of psychiatric disorders. Individual who are older, with more severe presenting complaints at triage, who arrive by ambulance/police, and who have longer lengths of stay are more likely to require a psychiatric admission. Individuals with mood and psychotic disorders are more likely to require a hospital admission. By establishing factors across conditions that increase the risk of admission, it is possible that this information can be used to better inform the provision of post-triage support for more vulnerable patients. Abstract: Background: Rising psychiatric visits represent a significant and growing burden for emergency departments (EDs) across Canada. For individual psychiatric conditions, there are likely a variety of demographic and social variables that may increase risk of resource intensive hospital admission. Methods: We conducted a retrospective cohort study of all patients admitted into inpatient psychiatric units from two EDs in Kingston, Ontario, Canada from 2015 to 2018. We collected demographic and social variables from an electronic ED information system inclusive of all patients presenting to the ED with a mental health or addictions-related chief complaint. We used multivariate logistic regression models to identify predictors of psychiatric admission. Results: A total of 23, 814 patients (49.1% male, median age 33) were identified. Admitted patients (n=1838) tended to be older (49 vs. 31 years), have lower Canadian Triage Acuity Scale scores (2.6 vs. 3.0), arrive by ambulance (51% vs . 35%) or police (18% vs. 9%), and have longer lengths of stay (8.4 vs . 4.9 hours). Individuals with mood and psychotic disorders were more likely to require a hospital admission. Conclusion: A variety of clinical and demographic variables increased the risk of hospital admissions for individuals with a variety of psychiatric disorders.