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Epidemiologic Assessment of Mortality among Inpatients in a Psychiatric Hospital

Year 2023, Volume: 15 Issue: Supplement 1, 192 - 202, 29.12.2023
https://doi.org/10.18863/pgy.1343510

Abstract

Individuals with psychiatric disorders have higher early mortality rates than the general population, and all types of mental disorders are associated with a short life expectancy. In this context, assessment of the mortali-ties of both natural and unnatural causes in psychiatric inpatients is of critical importance in terms of mortality epidemiology, which provides data that can help improve the quality and planning of psychiatric care. The popu-lation of this study retrospective, cross-sectional study consisted of inpatients that died in Manisa Mental Health and Diseases Hospital between May 2002 and December 2022. Of the 120 inpatients that died, 119 patients, 63.9% male, and 36.1% female, were included in the study sample. The mortality rate decreased from 3.2% to 0.22% during the period covered by the study. The difference between mortality rates before 2013, when qua-lity and accreditation processes started, and after 2013 has decreased from 74.8% to 25.2%. Of the natural deaths, 45.4% were caused by cardiac arrest, whereas 100% of the unnatural deaths occurred due to suicides. Short hospital stays and close follow-up in the first week of hospitalization are essential in reducing mortality rates in psychiatric inpatients. In addition, increasing the quality of health care in accordance with the national and international quality and accreditation criteria will further reduce the mortality rates in psychiatric inpati-ents.

References

  • Alatas NAG (2001) Psikiyatride ani ölüm (Uzmanlık Tezi). İstanbul, Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi.
  • Bahorik AL, Satre DD, Kline-Simon AH, Weisner CM, Campbell CI (2017) Serious mental illness and medical comorbidities: findings from an integrated health care system. J Psychosom Res, 100:35–45.
  • Barbosa S, Sequeira M, Castro S, Manso R, Câmara CK, Trancas B et al. (2016) Causes of death in an acute psychiatric inpatient unit of a Portuguese general hospital. Acta Med Port, 29:468–475.
  • Böke Ö, Sarısoy G, Aker S (2007) Deaths in mental health hospital: retrospective study. Noro Psikiyatri Ars, 44:54–57.
  • D Hernández-Calle, G Martínez-Alés, R Mediavilla, P Aguirre, B Rodriguez-Vega, MF Bravo-Ortiz (2020) Trends in psychiatric emergency department visits due to suicidal ideation and suicide attempts during the covid-19 pandemic in Madrid, Spain. J Clin Psychiatry, 81:22–27.
  • Delibaş DH, Aydın M, Satı- Kıran T, Oğuz EG, Karasu U, Şimşek Y et al. (2021) Clinical characteristics, additional medical diagnoses and causes of death of individuals with severe mental illness who died during October follow-up in community mental health centers: a multicenter, retrospective study. Turk Psikiyatri Derg, 32:246–252.
  • Firth J, Siddiqi N, Koyanagi A, Siskind D, Rosenbaum S, Galletly C et al. (2019) The Lancet Psychiatry commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry, 6:675–712.
  • Heilä H, Haukka J, Suvisaari J, Lönnqvist J (2005) Mortality among patients with schizophrenia and reduced psychiatric hospital care. Psychol Med, 35:725-732.
  • Hernandez JB, Kim PY (2022) Epidemiology Morbidity and Mortality. Treasure Island (FL), StatPearls Publishing.
  • Hewer W, Rössler W, Fätkenheuer B, Löffler W (1995) Mortality among patients in psychiatric hospitals in Germany. Acta Psychiatr Scand, 91:174–179.
  • Kavak DG (2018) Turkish health care quality and accreditation institute health accreditation standards. Saglikta Kalite ve Akreditasyon Dergisi, 1:14–20.
  • Kuo CW, Yang SC, Shih YF, Liao XM, Lin SH (2022) Typical antipsychotics is associated with increased risk of severe exacerbation in asthma patients: a nationwide population-based cohort study. BMC Pulm Med, 22:85.
  • Lambert AM, Parretti HM, Pearce E, Price MJ, Riley M, Ryan R et al. (2022) Temporal trends in associations between severe mental illness and risk of cardiovascular disease: A systematic review and meta-analysis. PLOS Med, 19:e1003960.
  • Laursen TM (2019) Causes of premature mortality in schizophrenia: a review of literature published in 2018. Curr Opin Psychiatry, 32:388–393.
  • Laursen TM (2011) Life expectancy among persons with schizophrenia or bipolar affective disorder. Schizophr Res, 131:101–104.
  • Lawrence D, Jablensky AV, Holman CDJ, Pinder TJ (2000) Mortality in Western Australian psychiatric patients. Soc Psychiatry Psychiatr Epidemiol, 35:341–347.
  • Malomo IO, Aina OF, Ladapo HTO, Owoeye AO (2003) Ten-year mortality review in a pioneer psychiatric hospital in West Africa. East Afr Med J, 80:379–383.
  • Osman AH, Abdalhai KA, Hassan I, Elmubark MA, Elawad LA (2020) Mortality characteristics in Sudan in national psychiatric hospitals: 5-year review of hospital mortality. Middle East Curr Psychiatry, 27:1-7.
  • Pérez-Cárceles MD, Íñigo C, Luna A, Osuna E (2001) Mortality in maximum security psychiatric hospital patients. Forensic Sci Int, 119:279–283.
  • Plana-Ripoll O, Dreier JW, Momen NC, Prior A, Weye N, Mortensen PB et al. (2022) Analysis of mortality metrics associated with a comprehensive range of disorders in Denmark, 2000 to 2018: A population-based cohort study. PLoS Med, 19:e1004023.
  • Plana-Ripoll O, Pedersen CB, Agerbo E, Holtz Y, Erlangsen A, Canudas-Romo V et al. (2019) A comprehensive analysis of mortality-related health metrics associated with mental disorders: a nationwide, register-based cohort study. Lancet, 394:1827–1835.
  • Schneider F, Erhart M, Hewer W, Loeffler LA, Jacobi F (2019) Mortality and medical comorbidity in the severely mentally ill: a German registry study. Dtsch Arztebl Int, 116:405-411.
  • Shinde SS, Nagarajaiah, Narayanaswamy JC, Viswanath B, Kumar NC, Gangadhar BN et al. (2014) Mortality among inpatients of a psychiatric hospital: Indian perspective. Indian J Psychol Med, 36:142–146.
  • Soygur H (2016) Community mental health services: quo vadis? Noro Psikiyatri Ars, 53:1–3.
  • Steblaj A, Tavcar R, Dernovsek MZ (2007) Predictors of suicide in psychiatric hospital. Acta Psychiatr Scand, 100:383–388.
  • Suetani S, Whiteford HA, McGrath JJ (2015) An urgent call to address the deadly consequences of serious mental disorders. JAMA Psychiatry, 72:1166-1167.
  • Swaraj S, Wang M, Chung D, Curtis J, Firth J, Ramanuj PP (2019) Meta‐analysis of natural, unnatural and cause‐specific mortality rates following discharge from in‐patient psychiatric facilities. Acta Psychiatr Scand, 140:244–264.
  • Thomas T (2018) Prevention of inpatient suicides: an attempt to portray an approach. Kerala J Psychiatry, 30:93–102.
  • Uchida H, Suzuki T (2005) Cardiac sudden death in psychiatric patients. Can J Psychiatry, 60:203–205.
  • Walker ER, McGee RE, Druss BG (2015) Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry, 72:334–341.
  • Wilson R, Gaughran F, Whitburn T, Higginson IJ, Gao W (2019) Place of death and other factors associated with unnatural mortality in patients with serious mental disorders: population-based retrospective cohort study. BJPsych Open, 5:23.
  • Woudenberg-van den Broek CM, van der Velden K, Duijst-Heesters WLJM (2022) What’s in a name? A discussion on the definition of natural and unnatural causes of death. Philos Ethics Humanit Med, 17:14.

Bir Psikiyatri Hastanesinde Yatan Hastalardaki Ölümlerin Epidemiyolojik Değerlendirilmesi

Year 2023, Volume: 15 Issue: Supplement 1, 192 - 202, 29.12.2023
https://doi.org/10.18863/pgy.1343510

Abstract

Ruhsal bozukluğu olan bireylerin genel nüfusa göre daha yüksek erken ölüm oranlarına sahip olduğu ve tüm ruhsal bozukluk türlerinin kısa yaşam beklentisi ile ilişkili olduğu bilinmektedir. Bu bağlamda, psikiyatrik yatan hastalarda hem doğal hem de doğal olmayan nedenlerden kaynaklanan ölümlerin değerlendirilmesi, psikiyatrik bakımın kalitesini ve planlamasını iyileştirmeye yardımcı olabilecek veriler sağlayan mortalite epidemiyolojisi açısından kritik öneme sahiptir. Bu retrospektif, kesitsel çalışmanın evrenini Mayıs 2002-Aralık 2022 tarihleri arasında Manisa Ruh Sağlığı ve Hastalıkları Hastanesi'nde yatarak tedavi gören ve ölen hastalar oluşturmaktadır. Yatarak tedavi gören 120 hastadan %63,9'u erkek, %36,1'i kadın olmak üzere 119 hasta çalışma örneklemine dahil edilmiştir. Çalışmanın kapsadığı dönem boyunca ölüm oranı %3,2'den %0,22'ye düşmüştür. Kalite ve akre-ditasyon süreçlerinin başladığı yıl olan 2013 öncesi ölüm oranları ile 2013 sonrası fark ise %74.8’den %25.2’ye gerilemiştir. Doğal ölümlerin %45,4'ü kardiyak arrest nedeniyle gerçekleşirken, doğal olmayan ölümlerin %100'ü intihar nedeniyle meydana gelmiştir. Kısa hastanede kalış süreleri ve hastaneye yatışın ilk haftasında yakın takip, psikiyatrik yatan hastalarda ölüm oranlarını azaltmada esastır. Ayrıca, ulusal ve uluslararası kalite ve akreditasyon kriterlerine uygun olarak sağlık bakım kalitesinin artırılması, psikiyatrik yatan hastalarda ölüm oranlarını daha da azaltacaktır.

References

  • Alatas NAG (2001) Psikiyatride ani ölüm (Uzmanlık Tezi). İstanbul, Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi.
  • Bahorik AL, Satre DD, Kline-Simon AH, Weisner CM, Campbell CI (2017) Serious mental illness and medical comorbidities: findings from an integrated health care system. J Psychosom Res, 100:35–45.
  • Barbosa S, Sequeira M, Castro S, Manso R, Câmara CK, Trancas B et al. (2016) Causes of death in an acute psychiatric inpatient unit of a Portuguese general hospital. Acta Med Port, 29:468–475.
  • Böke Ö, Sarısoy G, Aker S (2007) Deaths in mental health hospital: retrospective study. Noro Psikiyatri Ars, 44:54–57.
  • D Hernández-Calle, G Martínez-Alés, R Mediavilla, P Aguirre, B Rodriguez-Vega, MF Bravo-Ortiz (2020) Trends in psychiatric emergency department visits due to suicidal ideation and suicide attempts during the covid-19 pandemic in Madrid, Spain. J Clin Psychiatry, 81:22–27.
  • Delibaş DH, Aydın M, Satı- Kıran T, Oğuz EG, Karasu U, Şimşek Y et al. (2021) Clinical characteristics, additional medical diagnoses and causes of death of individuals with severe mental illness who died during October follow-up in community mental health centers: a multicenter, retrospective study. Turk Psikiyatri Derg, 32:246–252.
  • Firth J, Siddiqi N, Koyanagi A, Siskind D, Rosenbaum S, Galletly C et al. (2019) The Lancet Psychiatry commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry, 6:675–712.
  • Heilä H, Haukka J, Suvisaari J, Lönnqvist J (2005) Mortality among patients with schizophrenia and reduced psychiatric hospital care. Psychol Med, 35:725-732.
  • Hernandez JB, Kim PY (2022) Epidemiology Morbidity and Mortality. Treasure Island (FL), StatPearls Publishing.
  • Hewer W, Rössler W, Fätkenheuer B, Löffler W (1995) Mortality among patients in psychiatric hospitals in Germany. Acta Psychiatr Scand, 91:174–179.
  • Kavak DG (2018) Turkish health care quality and accreditation institute health accreditation standards. Saglikta Kalite ve Akreditasyon Dergisi, 1:14–20.
  • Kuo CW, Yang SC, Shih YF, Liao XM, Lin SH (2022) Typical antipsychotics is associated with increased risk of severe exacerbation in asthma patients: a nationwide population-based cohort study. BMC Pulm Med, 22:85.
  • Lambert AM, Parretti HM, Pearce E, Price MJ, Riley M, Ryan R et al. (2022) Temporal trends in associations between severe mental illness and risk of cardiovascular disease: A systematic review and meta-analysis. PLOS Med, 19:e1003960.
  • Laursen TM (2019) Causes of premature mortality in schizophrenia: a review of literature published in 2018. Curr Opin Psychiatry, 32:388–393.
  • Laursen TM (2011) Life expectancy among persons with schizophrenia or bipolar affective disorder. Schizophr Res, 131:101–104.
  • Lawrence D, Jablensky AV, Holman CDJ, Pinder TJ (2000) Mortality in Western Australian psychiatric patients. Soc Psychiatry Psychiatr Epidemiol, 35:341–347.
  • Malomo IO, Aina OF, Ladapo HTO, Owoeye AO (2003) Ten-year mortality review in a pioneer psychiatric hospital in West Africa. East Afr Med J, 80:379–383.
  • Osman AH, Abdalhai KA, Hassan I, Elmubark MA, Elawad LA (2020) Mortality characteristics in Sudan in national psychiatric hospitals: 5-year review of hospital mortality. Middle East Curr Psychiatry, 27:1-7.
  • Pérez-Cárceles MD, Íñigo C, Luna A, Osuna E (2001) Mortality in maximum security psychiatric hospital patients. Forensic Sci Int, 119:279–283.
  • Plana-Ripoll O, Dreier JW, Momen NC, Prior A, Weye N, Mortensen PB et al. (2022) Analysis of mortality metrics associated with a comprehensive range of disorders in Denmark, 2000 to 2018: A population-based cohort study. PLoS Med, 19:e1004023.
  • Plana-Ripoll O, Pedersen CB, Agerbo E, Holtz Y, Erlangsen A, Canudas-Romo V et al. (2019) A comprehensive analysis of mortality-related health metrics associated with mental disorders: a nationwide, register-based cohort study. Lancet, 394:1827–1835.
  • Schneider F, Erhart M, Hewer W, Loeffler LA, Jacobi F (2019) Mortality and medical comorbidity in the severely mentally ill: a German registry study. Dtsch Arztebl Int, 116:405-411.
  • Shinde SS, Nagarajaiah, Narayanaswamy JC, Viswanath B, Kumar NC, Gangadhar BN et al. (2014) Mortality among inpatients of a psychiatric hospital: Indian perspective. Indian J Psychol Med, 36:142–146.
  • Soygur H (2016) Community mental health services: quo vadis? Noro Psikiyatri Ars, 53:1–3.
  • Steblaj A, Tavcar R, Dernovsek MZ (2007) Predictors of suicide in psychiatric hospital. Acta Psychiatr Scand, 100:383–388.
  • Suetani S, Whiteford HA, McGrath JJ (2015) An urgent call to address the deadly consequences of serious mental disorders. JAMA Psychiatry, 72:1166-1167.
  • Swaraj S, Wang M, Chung D, Curtis J, Firth J, Ramanuj PP (2019) Meta‐analysis of natural, unnatural and cause‐specific mortality rates following discharge from in‐patient psychiatric facilities. Acta Psychiatr Scand, 140:244–264.
  • Thomas T (2018) Prevention of inpatient suicides: an attempt to portray an approach. Kerala J Psychiatry, 30:93–102.
  • Uchida H, Suzuki T (2005) Cardiac sudden death in psychiatric patients. Can J Psychiatry, 60:203–205.
  • Walker ER, McGee RE, Druss BG (2015) Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry, 72:334–341.
  • Wilson R, Gaughran F, Whitburn T, Higginson IJ, Gao W (2019) Place of death and other factors associated with unnatural mortality in patients with serious mental disorders: population-based retrospective cohort study. BJPsych Open, 5:23.
  • Woudenberg-van den Broek CM, van der Velden K, Duijst-Heesters WLJM (2022) What’s in a name? A discussion on the definition of natural and unnatural causes of death. Philos Ethics Humanit Med, 17:14.
There are 32 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Research
Authors

Cengiz Cengisiz 0000-0001-5552-8767

Lut Tamam 0000-0002-9750-7531

Ezgi Paşaoğlu 0000-0002-0972-5273

Early Pub Date September 29, 2023
Publication Date December 29, 2023
Acceptance Date September 17, 2023
Published in Issue Year 2023 Volume: 15 Issue: Supplement 1

Cite

AMA Cengisiz C, Tamam L, Paşaoğlu E. Epidemiologic Assessment of Mortality among Inpatients in a Psychiatric Hospital. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. December 2023;15(Supplement 1):192-202. doi:10.18863/pgy.1343510

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