Mortality of gerontopsychiatric inpatients in Graz, Austria-aretrospective case-control study

Abstract

Despite the demographic development and the increasing number of psychiatric diseases in older people, there are only few scientific investigations on the characteristics of patients in gerontopsychiatry and their mortality. In this retrospective case control study patient data were examined in order to establish which features of patients who died in a department of gerontopsychiatry show differences to those of patients who were discharged. A total of 284 patient files from the department of gerontopsychiatry and geriatric psychotherapy of the State Hospital Graz II were evaluated. Between 1 January 2015 and 31 December 2017, a total of 51 women and 91 men died (= cases) in hospital. These patients were compared with 142 sex-matched patients (control group) who were discharged during the same period of time. The evaluation was carried out using logistic regression models. Patients who died on the geriatric psychiatry ward were clearly older and were in a clearly poorer physical state of health than the discharged patients. The deceased patients had a 2.7-fold higher chance of an ischemic cardiac disease as well as a 2.5-fold and 3.5-fold higher chance of being referred from a nursing home or hospital, respectively. They also had a threefold higher chance for a lower functional status, a fourfold increased chance of higher C‑reactive protein (CRP) values and a diagnosis of delirium compared to discharged patients. The deceased patients had a substantially poorer state of health and tended to suffer more from delirium compared to the discharged patients. Structural health policy precautions must be undertaken so that unnecessary transfers to gerontopsychiatry departments do not become necessary.