title: Increased risks of acute organ dysfunction and mortality in intensive care unit patients with schizophrenia: a nationwide population-based study.
abstract: OBJECTIVE
  To investigate the risks of acute organ dysfunction and death in intensive care unit (ICU) patients with schizophrenia.
  
  
  METHODS
  Using a retrospective matched cohort design, we compared 203 schizophrenic patients to 2036 demographically matched (1:10) nonschizophrenic patients with first-time ICU admission between 2005 and 2007 using the claims data of a nationally representative cohort from the Taiwan National Health Insurance Research Database. Definitions of schizophrenia and associated diagnoses were based on the codes of the International Classification of Diseases, Ninth Revision, Clinical Modification. Analyses were performed using univariate and multivariate analyses.
  
  
  RESULTS
  The median age of schizophrenic patients was 53 years; 61.1% were men. Schizophrenic patients were less likely to be hospitalized in a medical center and had fewer surgical conditions and principal cardiovascular diagnoses, but they had a higher prevalence of infection than nonschizophrenic patients. After controlling for the aforementioned baseline covariates, schizophrenic patients had a higher risk of acute organ dysfunction (adjusted odds ratio = 1.52, 95% confidence interval = 1.09-2.10). When individual organ systems were analyzed, they had a 47% higher risk of respiratory dysfunction, a 194% higher risk of renal dysfunction, and a 122% higher risk of neurological dysfunction than nonschizophrenic patients. Hospital mortality was also higher in schizophrenic patients than in nonschizophrenic patients (24.1% versus 14.4%, p < .001; adjusted odds ratio = 1.56, 95% confidence interval = 1.08-2.24).
  
  
  CONCLUSIONS
  Among ICU patients, schizophrenic patients were sicker, having a higher risk of acute organ dysfunction and death.
authors.affiliation: Department of Medical Research, Chi Mei Medical Center, No 901 Chung-Hwa Rd, Yong-Kang City, Tainan, Taiwan.
authors.forename: Hsiu-Nien
authors.initials: HN
authors.lastname: Shen
authors.forename: Chin-Li
authors.initials: CL
authors.lastname: Lu
authors.forename: Hsi-Hsing
authors.initials: HH
authors.lastname: Yang
mesh_terms: D000208:Acute Disease / Q000401:mortality; D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications*; D018709:Statistics, Nonparametric