Mortality in medical-surgical inpatients referred for psychiatric consultation.
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.


METHODS
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.


CONCLUSIONS
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.
Tennen
Gayla B
GB
Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario M4N 3M5, Canada. gayla.tennen@sunnybrook.ca
Rundell
James R
JR
Stevens
Susanna R
SR
D000203:Activities of Daily Living; D000368:Aged; D015897:Comorbidity; D003693:Delirium / Q000150:complications / Q000401:mortality; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000401:mortality; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009026:Mortality; D009369:Neoplasms / Q000150:complications / Q000401:mortality; D015995:Prevalence; D016016:Proportional Hazards Models; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors