Mortality in medical-surgical inpatients referred for psychiatric consultation

Gen Hosp Psychiatry. 2009 Jul-Aug;31(4):341-6. doi: 10.1016/j.genhosppsych.2009.03.011. Epub 2009 May 2.

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.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Comorbidity
  • Delirium / complications
  • Delirium / mortality
  • Female
  • Humans
  • Inpatients / statistics & numerical data*
  • Kaplan-Meier Estimate
  • Male
  • Mental Disorders* / complications
  • Mental Disorders* / mortality
  • Middle Aged
  • Minnesota / epidemiology
  • Mortality*
  • Neoplasms / complications
  • Neoplasms / mortality
  • Prevalence
  • Proportional Hazards Models
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Survival Rate
  • Time Factors