What is the risk of returning to the emergency department within 30 days for patients diagnosed with substance-induced psychosis?,Canadian Journal of Emergency Medicine

当前位置： X-MOL 学术 › Can. J. Emerg. Med. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

What is the risk of returning to the emergency department within 30 days for patients diagnosed with substance-induced psychosis?
Canadian Journal of Emergency Medicine ( IF 2.0 ) Pub Date : 2022-09-15 , DOI: 10.1007/s43678-022-00364-3
David Barbic _{1,

2} , Madelyn Whyte ₃ , Gurwinder Sidhu ₄ , Allesandra Luongo ₅ , Robert Stenstrom ₁ , Tapash Apu Chakraborty ₆ , Frank Scheuermeyer _{1,

2} , William G Honer _{6,

7} , Daniel J Lane ₁

Affiliation

Objectives

The primary objective of this study was to measure the risk of return Emergency Department (ED) visits in patients presenting to the ED with a diagnosis of substance-induced psychosis. Secondary objectives included: (1) describing the characteristics of patients returning within 30 days to the ED with substance-induced psychosis, and (2) identifying risk factors associated with such ED return.

Methods

At two urban sites from January 1, 2018 to December 31, 2019, we included consecutive patients presenting to the ED with substance-induced psychosis defined by their ED discharge diagnosis of psychosis and clinical evidence of substance use. We described ED resources utilized by this patient population including ED time and disposition then subsequently described return visits within 30 days and characteristics among those patients who returned.

Results

We identified 611 unique patients presenting with substance-induced psychosis, with 813 total ED visits. The median age was 35 years (IQR 28–45), 71.4% (n = 436) were male, and 44.8% (n = 274) were homeless. The median ED length of stay was 619 min (IQR 313–898), and 48.4% (n = 296) were admitted to hospital. Forty percent of patients (n = 237) returned to the ED within 30 days of the index substance-induced psychosis visit, 116 (18.9%) returning more than once. Of these return visits, 74 (31.2%) were for recurrent substance-induced psychosis. Younger age, female gender, no opioid use, and no prior history of bipolar disorder were identified as common characteristics among those returning to the ED with substance-induced psychosis.

Conclusions

In ED patients with substance-induced psychosis, nearly half of all patients were admitted to hospital, 40% had a 30 days return ED visit, and one-third of those were for substance-induced psychosis. We identified clinically relevant factors common to those returning with recurrent substance-induced psychosis.

中文翻译：

被诊断为物质诱发精神病的患者在 30 天内返回急诊室的风险是什么？

目标

本研究的主要目的是衡量被诊断为物质诱发精神病的急诊科 (ED) 患者返回急诊科 (ED) 就诊的风险。次要目标包括：(1) 描述在 30 天内因物质诱发的精神病返回急诊室的患者的特征，以及 (2) 确定与此类返回急诊室相关的风险因素。

方法

从 2018 年 1 月 1 日到 2019 年 12 月 31 日，在两个城市地点，我们纳入了连续出现在急诊室的患者，这些患者患有物质诱发的精神病，其定义为急诊室对精神病的出院诊断和物质使用的临床证据。我们描述了该患者群体使用的 ED 资源，包括 ED 时间和处置，然后描述了 30 天内的回访以及回访患者的特征。

结果

我们确定了 611 名出现物质诱发精神病的独特患者，总计 813 次急诊就诊。中位年龄为 35 岁 (IQR 28–45)，71.4% ( n = 436) 为男性，44.8% ( n = 274) 为无家可归者。急诊住院时间中位数为 619 分钟 (IQR 313–898)，48.4% ( n = 296) 入院。40% 的患者 ( n = 237) 在指数物质诱发精神病就诊后 30 天内返回急诊室，116 名 (18.9%) 返回不止一次。在这些回访中，74 人 (31.2%) 是针对复发性物质诱发的精神病。年轻、女性、未使用阿片类药物和既往无双相情感障碍病史被确定为因物质诱发精神病而返回急诊室的患者的共同特征。