Clinical and Epidemiological Characteristics of a Contingent of Elderly Patients Treated in the Somatopsychiatric Department of a Multi-Field Hospital

Abstract

Background: comorbidity of somatic and mental pathology is the most common reason that complicates the provision of medical care to the elderly even under the conditions of a specialized somatopsychiatric department (SPD) of a multi-field hospital, which dictates the need for further study of the clinical and epidemiological features of these patients population.The aim of the study was to investigate the clinical and epidemiological characteristics of a contingent of elderly patients treated over a year in SPD of a multi-field hospital in comparison with similar data from a psychiatric hospital. The objectives of the study were to analyze the demographic structure of this contingent, the distribution of various types (categories) of somatic and mental pathology, routes of admission, time and outcomes of treatment in SPD of a multidisciplinary hospital.Materials and methods: the research material was the medical documentation of a sample of patients treated during 2019 in the SPD of the City Clinical Hospital № 1 named after. N.I. Pirogov of the Moscow Department of Health Protection (the total number of patients treated was 3379 people, of which 1456 were aged 65 and older). To conduct a comparative analysis, we used data from an epidemiological study in a psychiatric hospital (City Psychiatric Hospital № 13 of the Moscow Department of Health Protection), conducted in the same 2019 year.Results: it was established that in the SPD of a multi-field hospital, care is provided to a heterogeneous (demographic and clinical-diagnostic) group of patients, predominantly of late age (65 years and older). The most common diagnosis is dementia of various origins, complicated by severe somatic pathology (acute or associated with decompensation of a chronic somatic disease).Conclusion: elderly and senile patients make up more than half of the contingent of patients treated in the SPD of a multidisciplinary hospital. Significant differences were revealed in the SPD diagnostic distribution of young-middle-aged and elderly patients. Special features of the gender and age distribution of patients in the indicated age groups were established. Data were obtained on a higher mortality rate for those aged 65 years and older. The presence of problems in providing care to patients of older age groups in SPD determines the need for its improvement. For this purpose, it is advisable to consider the issue of creating a model of SPD of geriatric profile in a multi-field hospital to provide emergency psychiatric and somatic care to elderly patients.