title: Identifying Patients in the Acute Psychiatric Hospital Who May Benefit From a Palliative Care Approach.
abstract: Identifying patients who will benefit from a palliative care approach is the first critical step in integrating palliative with curative therapy. Criteria are established that identify hospitalized medical patients who are near end of life, yet there are no criteria with respect to hospitalized patients with psychiatric disorders. The records of 276 consecutive patients admitted to a dedicated inpatient psychiatric unit were reviewed to identify prognostic criteria predictive of mortality. Mortality predictors were 2 or more admissions in the past year (P = .0114) and older age (P = .0006). Twenty-two percent of patients met National Hospice and Palliative Care Organization noncancer criteria for dementia. Palliative care intervention should be considered when treating inpatients with psychiatric disorders, especially older patients who have a previous hospitalization or history of dementia.
authors.affiliation: Department of Medicine, Mayo Clinic, Jacksonville, FL, USA burton.mcaroline@mayo.edu.
authors.forename: M Caroline
authors.initials: MC
authors.lastname: Burton
authors.affiliation: Department of Psychiatry, Mayo Clinic, Rochester, MN, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Warren
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Cha
authors.affiliation: Minnesota State University, Mankato Undergraduate University, Mankato, MN, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Stevens
authors.affiliation: University of St. Thomas, St. Paul, MN, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Blommer
authors.affiliation: Department of Psychiatry, Mayo Clinic, Rochester, MN, USA.
authors.forename: Simon
authors.initials: S
authors.lastname: Kung
authors.affiliation: Department of Psychiatry, Mayo Clinic, Rochester, MN, USA.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Lapid
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003704:Dementia / Q000401:mortality / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric / Q000458:organization & administration*; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000401:mortality* / Q000628:therapy*; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration*; D000070659:Patient Comfort / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment
keywords: dementia; hospice; hospital medicine; mortality; palliative medicine; prognosis