<p>Retrospective Analysis of Factors Associated with Long-Stay Hospitalizations in an Acute Psychiatric Ward</p>

Introduction: The aim of this study was to identify factors associated with primary graft patency 1 year following open lower limb revascularisation (LLR) at a tertiary referral vascular service. Methods: A retrospective analysis of patients undergoing infra-inguinal bypass surgery between January 2016 and May 2017 at a tertiary vascular centre (St Mary’s Hospital, London) was performed. Data regarding patient demographics, comorbidities, type of operation and post-operative anti-thrombotic strategy were collected. Quality of run-off score was assessed from pre-operative imaging. Results: Seventy-seven cases were included in the analysis. Overall, the primary patency rate at 1-year was 63.6% ( n = 49/77) and the secondary patency rate was 67.5% ( n = 52/77). Independent variables with statistically significant inferior patency rates at 1-year were (1) bypasses with below knee targets (p = 0.0096), (2) chronic limb threatening ischaemia indication (p = 0.038), (3) previous ipsilateral revascularisation (p < 0.001) and (4) absence of hypertension history (p = 0.041). There was also a trend towards significance for American Society of Anesthesiologists (ASA) grade (p = 0.06). Independent variables with log-rank test p values of <0.1 were included in a Cox proportional hazards model. The only variable with a statistically significant impact on primary patency rates was previous open or endovascular ipsilateral revascularisation (HR 2.44 (1.04–5.7), p = 0.04). Conclusion: At 1-year follow-up, previous ipsilateral revascularisation was the most significant factor in affecting patency rates. Patients in this subgroup should therefore be deemed high-risk, which should be reflected in the informed consent and peri-operative management.

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The relationship of insight with psychopathological dimensions in patients with schizophrenia

Journal of Experimental Psychopathology ◽

10.1177/20438087211019932 ◽

2021 ◽

Vol 12 (2) ◽

pp. 204380872110199

Author(s):

Si-Sheng Huang ◽

Cheng-Chen Chang

Keyword(s):

Medical Center ◽

Self Report ◽

Psychiatric Ward ◽

Neurocognitive Functions ◽

Bivariate Correlation ◽

Syndrome Scale ◽

Acute Psychiatric Ward ◽

Negative Syndrome ◽

Relationship Of ◽

The Relationship

Impaired insight in patients with schizophrenia results in less satisfactory clinical outcomes. This study was conducted to investigate the relationship between insight and individual psychopathological dimensions in inpatients with schizophrenia using a self-report questionnaire. In this study, 90 patients with schizophrenia aged 18–75 years admitted in the acute psychiatric ward of a medical center in Taiwan were enrolled. Patient insight was measured using the Self-Appraisal of Illness Questionnaire (SAIQ), and psychopathological dimensions were measured using the Positive and Negative Syndrome Scale (PANSS) and its five-factor structure model. A higher SAIQ score indicates greater insight. In bivariate correlation analyses, statistically significant correlations were observed between age, single marital status, educational level, and positive, excited, and depressed symptom factor of the PANSS and SAIQ score. In regression analyses, age and excited and depressed symptom factors were significantly associated with SAIQ score. No significant association was observed between insight and neurocognitive functions. Considering demographic characteristics, psychopathology, and neurocognition, in the acute phase of schizophrenia, younger patients with less severe excited symptoms and more severe depressive symptoms had greater insight.

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Unlocking an acute psychiatric ward: The impact on unauthorised absences, assaults and seclusions

BJPsych Bulletin ◽

10.1192/pb.bp.115.052944 ◽

2017 ◽

Vol 41 (2) ◽

pp. 92-96 ◽

Cited By ~ 4

Author(s):

Ben Beaglehole ◽

John Beveridge ◽

Warren Campbell-Trotter ◽

Chris Frampton

Keyword(s):

Psychiatric Inpatient ◽

Psychiatric Ward ◽

Inpatient Service ◽

Positive Effects ◽

Adverse Event Data ◽

Before And After ◽

Acute Psychiatric Ward ◽

Restrictive Environment ◽

Open Wards ◽

The Impact

Aims and methodThe acute psychiatric inpatient service in Christchurch, New Zealand, recently changed from two locked and two unlocked wards to four open wards. This provided the opportunity to evaluate whether shifting to an unlocked environment was associated with higher rates of adverse events, including unauthorised absences, violent incidents and seclusion. We compared long-term adverse event data before and after ward configuration change.ResultsRates of unauthorised absences increased by 58% after the change in ward configuration (P = 0.005), but seclusion hours dropped by 53% (P = 0.001). A small increase in violent incidents was recorded but this was not statistically significant.Clinical implicationsAlthough unauthorised absences increased, the absence of statistically significant changes for violent incidents and a reduction in seclusion hours suggest that the change to a less restrictive environment may have some positive effects.

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