Gayla B Tennen1, James R Rundell, Susanna R Stevens. 1. Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario M4N 3M5, Canada. gayla.tennen@sunnybrook.ca
Abstract
OBJECTIVE: The purpose of this study is to calculate the 1-year mortality rate of medical-surgical inpatients referred for psychiatric consultation and to determine factors associated with mortality in this population. METHOD: We conducted a retrospective chart review of medical-surgical inpatients referred for psychiatric consultation (N=454). Patients who died within 1 year of psychiatric consultation were compared to age-matched patients from the same group who survived on demographic and clinical domains. RESULTS: Sixty-nine patients (15.2%) died within 1 year of referral for psychiatric consultation. Delirium was the only psychiatric diagnosis significantly associated with 1-year mortality [52.2% vs. 29.9%, P=.01; hazard ratio (HR), 1.7]. Cancer was the only medical condition associated with 1-year mortality (24.6% vs. 6.0%, P<.0001; HR, 3.03). Having both delirium and cancer shortened mean survival time significantly. Mortality risk was also associated with time duration between admission and psychiatric consultation. CONCLUSION: The 1-year mortality rate in this group of medical-surgical inpatients referred for psychiatric consultation was 15.2%. Mortality was independently associated with delirium and cancer. Mortality was also associated with greater length of time from admission to consultation, which raises a question about whether earlier psychiatry consultation may have a positive impact on survival.
OBJECTIVE: The purpose of this study is to calculate the 1-year mortality rate of medical-surgical inpatients referred for psychiatric consultation and to determine factors associated with mortality in this population. METHOD: We conducted a retrospective chart review of medical-surgical inpatients referred for psychiatric consultation (N=454). Patients who died within 1 year of psychiatric consultation were compared to age-matched patients from the same group who survived on demographic and clinical domains. RESULTS: Sixty-nine patients (15.2%) died within 1 year of referral for psychiatric consultation. Delirium was the only psychiatric diagnosis significantly associated with 1-year mortality [52.2% vs. 29.9%, P=.01; hazard ratio (HR), 1.7]. Cancer was the only medical condition associated with 1-year mortality (24.6% vs. 6.0%, P<.0001; HR, 3.03). Having both delirium and cancer shortened mean survival time significantly. Mortality risk was also associated with time duration between admission and psychiatric consultation. CONCLUSION: The 1-year mortality rate in this group of medical-surgical inpatients referred for psychiatric consultation was 15.2%. Mortality was independently associated with delirium and cancer. Mortality was also associated with greater length of time from admission to consultation, which raises a question about whether earlier psychiatry consultation may have a positive impact on survival.