From psychiatric to critical care: Patient profile and predictive transfer elements

Abstract

IntroductionPatients with mental illness have an increased risk of morbidity and mortality from somatic complications, with a reduction in life expectancy of 15 to 30 years. During hospitalization in a psychiatric setting multiple risk factors can combine and contribute to a severe deterioration in the general condition of patients who may require reanimation.AimDescribe the profile of patients admitted to Razi who required transfer to an intensive care setting during hospitalization to more precisely determine the predictors of severe somatic decompensation.MethodologyA descriptive retrospective study of patients transferred from the Razi hospital to the emergency medical assistance center (CAMU) during the period between 1 January 2014 and 31 December 2015.ResultsThe average age of patients was 39.5 years; 64.2% of the patients were men, 60% had a low socio-economic level, 34.7% had a comorbid disease. Forty-one percent (41%) of the patients transferred had been diagnosed with schizophrenia, and 27% had bipolar disorder. Antipsychotics were the most prescribed psychotropic drugs. High doses were used with therapeutic combinations in 85% of the cases. A toxic cause was identified in 58% of cases, including neuroleptic malignant syndrome in 18%. Dehydration and ionic disorders are among the most frequent causes in 27% of cases. Conclusion; Identifying risk factors for deaths in psychiatric hospitals highlights needed changes in psychiatric management strategies taking into account the patient's characteristics as well as the drugs’ safety profile.Disclosure of interestThe authors have not supplied their declaration of competing interest.