scholarly journals Physical Comorbidity According to Diagnoses and Sex among Psychiatric Inpatients in South Korea

2021 ◽  
Vol 18 (8) ◽  
pp. 4187
Author(s):  
Suin Park ◽  
Go-Un Kim ◽  
Hyunlye Kim
Keyword(s):  
Liver Disease ◽  
Mood Disorders ◽  
Pulmonary Disease ◽  
Mental Health Professionals ◽  
Neurological Disorders ◽  
Psychiatric Patients ◽  
Psychiatric Inpatients ◽  
Chronic Pulmonary Disease ◽  
Uncomplicated Hypertension ◽  
Physical Diseases

People with mental disorders are susceptible to physical comorbidities. Mind–body interventions are important for improving health outcomes. We examined the prevalence of physical comorbidities and their differences by diagnoses and sex among psychiatric inpatients. The dataset, from National Health Insurance claims data, included 48,902 adult inpatients admitted to psychiatric wards for at least 2 days in 2016 treated for schizophrenia, schizotypal and delusional disorders, or mood disorders. We identified 26 physical comorbidities using the Elixhauser comorbidity measure. Among schizophrenia-related disorders, other neurological disorders were most common, then liver disease and chronic pulmonary disease. Among mood disorders, liver disease was most common, then uncomplicated hypertension and chronic pulmonary disease. Most comorbid physical diseases (except other neurological disorders) were more prevalent in mood disorders than schizophrenia-related disorders. Male and female patients with schizophrenia-related disorders showed similar comorbidity prevalence patterns by sex. Among patients with mood disorders, liver disease was most prevalent in males and third-most in females. In both diagnostic groups, liver disease and uncomplicated diabetes mellitus were more prevalent in males, and hypothyroidism in females. Mental health professionals should refer to a specialist to manage physical diseases via early assessments and optimal interventions for physical comorbidities in psychiatric patients.

scholarly journals Impact of Comorbidities on Beneficial Effect of Lactated Ringers vs. Saline in Sepsis Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Chien-Hua Tseng ◽  
Tzu-Tao Chen ◽  
Ming-Cheng Chan ◽  
Kuan-Yuan Chen ◽  
Sheng-Ming Wu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Liver Disease ◽  
Kidney Disease ◽  
Pulmonary Disease ◽  
Saline Group ◽  
Serum Lactate ◽  
Chronic Pulmonary Disease ◽  
Central Venous ◽  
Severe Liver ◽  
Severe Liver Disease

Background: Lactated Ringers reduced mortality more than saline in sepsis patients but increased mortality more than saline in traumatic brain injury patients.Method: This prospective cohort study was conducted in a medical intensive care unit (ICU) in central Taiwan. We applied standard sepsis evaluation protocol and identified heart, lung, liver, kidney, and endocrine comorbidities. We also evaluated resuscitation response with central venous pressure, central venous oxygen saturation, and serum lactate level simultaneously. Propensity-score matching and Cox regression were used to estimate mortality. The competing risk model compared the lengths of hospital stays with the subdistribution hazard ratio (SHR).Results: Overall, 938 patients were included in the analysis. The lactated Ringers group had a lower mortality rate (adjusted hazard ratio, 0.59; 95% CI 0.43-0.81) and shorter lengths of hospital stay (SHR, 1.39; 95% C.I. 1.15-1.67) than the saline group; the differences were greater in patients with chronic pulmonary disease and small and non-significant in those with chronic kidney disease, moderate to severe liver disease and cerebral vascular disease. The resuscitation efficacy was the same between fluid types, but serum lactate levels were significantly higher in the lactated Ringers group than in the saline group (0.12 mg/dl/h; 95% C.I.: 0.03, 0.21), especially in chronic liver disease patients. Compared to the saline group, the lactated Ringers group achieved target glucose level earlier in both diabetes and non-diabetes patients.Conclusion: Lactate Ringer's solution provides greater benefits to patients with chronic pulmonary disease than to those with chronic kidney disease, or with moderate to severe liver disease. Comorbidities are important in choosing resuscitation fluid types.

Comparison of Risk Factors of Falling for Psychiatric Inpatients and General Ward Inpatients Who Had Fallen

2021 ◽  
pp. 107839032110330
Author(s):  
Wen P. Chang ◽  
Hsiu J. Jen
Keyword(s):  
Risk Factors ◽  
Multinomial Logistic Regression ◽  
Psychiatric Patients ◽  
Length Of Hospital Stay ◽  
Psychiatric Inpatients ◽  
General Ward ◽  
Prevention Measures ◽  
Risk Of Falling ◽  
Multinomial Logistic Regression Analysis ◽  
Risk Factors For Falling

BACKGROUND: For psychiatric patients, the issue of falling is complex. OBJECTIVE: The objective of this study was to compare the risk factors for falling in psychiatric inpatients and general ward inpatients who had fallen. METHODS: The researchers first derived official fall records for 122 psychiatric inpatients and then selected 122 psychiatric inpatients who had not fallen as well as 122 general ward patients who had fallen, matched for gender, age, and length of hospital stay at the time of the fall incident. RESULTS: After controlling other variables, multinomial logistic regression analysis revealed that psychiatric inpatients who had fallen and had dizziness (odds ratio [OR] = 7.11, p < .001), had an unsteady gait (OR = 1.97, p = .030), or were not using aids (OR = 0.42, p = .042) were at greater risk of falling than those who had not fallen. The researchers also found that general ward inpatients who had fallen and had higher Charlson Comorbidity Index scores (OR = 1.77, p < .001), were clear-headed (OR = 27.15, p = .001), had dizziness (OR = 11.55, p < .001), were unable to walk (OR = 64.28, p < .001), or were using aids (OR = 3.86, p = .001) were at greater risk of falling than those who had not fallen before. CONCLUSIONS: The causes of falling among psychiatric inpatients and general ward inpatients are different. Medical personnel should understand the medications and attributes of patients for an accurate assessment of their risk factors for falling and thus implement fall prevention measures and health education to reduce falls.

Characteristics and outcomes of acute COVID-19 infection in paediatric and young adult patients with underlying cardiac disease

2021 ◽  
pp. 1-7
Author(s):  
Joshua M. Fisher ◽  
Sarah Badran ◽  
John T. Li ◽  
Jodie K. Votava-Smith ◽  
Patrick M. Sullivan
Keyword(s):  
Risk Factors ◽  
Young Adult ◽  
Pulmonary Disease ◽  
Cardiac Disease ◽  
Single Ventricle ◽  
Cardiac Risk ◽  
Adult Patients ◽  
Chronic Pulmonary Disease ◽  
Cardiac Risk Factors ◽  
Increased Risk

Abstract Objective To describe outcomes of acute coronavirus disease 2019 in paediatric and young adult patients with underlying cardiac disease and evaluate the association between cardiac risk factors and hospitalisation. Study design We conducted a retrospective single-institution review of patients with known cardiac disease and positive severe acute respiratory syndrome coronavirus 2 RT-PCR from 1 March, 2020 to 30 November, 2020. Extracardiac comorbidities and cardiac risk factors were compared between those admitted for coronavirus disease 2019 illness and the rest of the cohort using univariate analysis. Results Forty-two patients with a mean age of 7.7 ± 6.7 years were identified. Six were 18 years of age or more with the oldest being 22 years of age. Seventy-six percent were Hispanic. The most common cardiac diagnoses were repaired cyanotic (n = 7, 16.6%) and palliated single ventricle (n = 7, 16.6%) congenital heart disease. Fourteen patients (33.3%) had underlying syndromes or chromosomal anomalies, nine (21%) had chronic pulmonary disease and eight (19%) were immunosuppressed. Nineteen patients (47.6%) reported no symptoms. Sixteen (38.1%) reported only mild symptoms. Six patients (14.3%) were admitted to the hospital for acute coronavirus disease 2019 illness. Noncardiac comorbidities were associated with an increased risk of hospitalisation (p = 0.02), particularly chronic pulmonary disease (p = 0.01) and baseline supplemental oxygen requirement (p = 0.007). None of the single ventricle patients who tested positive required admission. Conclusions Hospitalisations for coronavirus disease 2019 were rare among children and young adults with underlying cardiac disease. Extracardiac comorbidities like pulmonary disease were associated with increased risk of hospitalisation while cardiac risk factors were not.

scholarly journals Statin for Tuberculosis and Pneumonia in Patients with Asthma–Chronic Pulmonary Disease Overlap Syndrome: A Time-Dependent Population-Based Cohort Study

2018 ◽  
Vol 7 (11) ◽  
pp. 381 ◽  
Author(s):  
Jun-Jun Yeh ◽  
Cheng-Li Lin ◽  
Chung-Y. Hsu ◽  
Zonyin Shae ◽  
Chia-Hung Kao
Keyword(s):  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Population Based ◽  
Overlap Syndrome ◽  
Time Dependent ◽  
Research Database ◽  
Chronic Pulmonary Disease ◽  
Oral Steroids ◽  
Taiwan National Health Insurance ◽  
Study Participants

We investigated the effects of statins on tuberculosis (TB) and pneumonia risks in asthma–chronic pulmonary disease overlap syndrome (ACOS) patients. We extracted data of patients diagnosed as having ACOS during 2000–2010 from the Taiwan National Health Insurance Research Database and divided them into statin users and nonusers. All study participants were followed up from the index date until death, withdrawal from insurance, or TB and pneumonia occurred (31 December 2011). The cumulative TB and pneumonia incidence was analyzed using Cox proportional regression analysis with time-dependent variables. After adjustments for multiple confounding factors including age, sex, comorbidities, and use of medications [statins, inhaled corticosteroids (ICSs), or oral steroids (OSs)], statin use was associated with significantly lower TB [adjusted hazard ratio (aHR) 0.49, 95% confidence interval (CI) 0.34–0.70] and pneumonia (aHR 0.52, 95% CI 0.41–0.65) risks. Moreover, aHRs (95% CIs) for statins combined with ICSs and OSs were respectively 0.60 (0.31–1.16) and 0.58 (0.40–0.85) for TB and 0.61 (0.39–0.95) and 0.57 (0.45–0.74) for pneumonia. Thus, statin users had lower TB and pneumonia risks than did nonusers, regardless of age, sex, comorbidities, and ICS or OS use. Pneumonia risk was lower among users of statins combined with ICSs or Oss and TB risk was lower among the users of statins combined with OSs.

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