Medical comorbidity related risk factors for hospital-based mortality in psychiatric disorders of ICD-10 classes F1–F4: A comparative overview of five studies in general hospital admissions

Abstract

IntroductionUp to 60% of the non-suicide related premature mortality of individuals with major psychiatric disorders is said to be mainly due to medical diseases.Objectives and aimsBased on five representative studies in general hospital admissions over 12.5-year observation, we will represent a comparative overview of medical comorbidity related risk factors for general hospital-based mortality in prevalent psychiatric disorders of ICD-10 major classes F1–F4.MethodsIn the original studies, medical comorbidities that increased the risk for hospital-based mortality were identified using multivariate forward logistic regression analysis. In secondary analysis, independent risk factors for general hospital-based mortality were compared between studies using the OR and the 95% CI.ResultsA total of fifteen medical comorbidities represented independent risk factors for general hospital-based mortality in more than one psychiatric disorder of ICD-10 major classes F1–F4. Infectious lung diseases and chronic obstructive pulmonary disease were mortality risk factors in all diagnostic classes. Type 2 diabetes mellitus represented a risk factor for general hospital-based mortality in individuals with schizophrenia (SCH), bipolar disorder (BD), and major depressive disorder (MDD). Atrial fibrillation was a mortality risk factor in individuals with MDD, anxiety disorder (ANX), and alcohol dependence (AD). In addition, nineteen medical comorbidities represented independent mortality risk factors in only one of the diagnostic classes, i.e. two in individuals with SCH, three in individuals with MDD, three in ANX, and eleven in AD.ConclusionsIn general hospitals, the pattern of medical comorbidities that explain the outcome of in-hospital deaths differs considerably between psychiatric disorders of ICD-10 major classes F1–F4.Disclosure of interestThe authors have not supplied their declaration of competing interest.