The Effects of Physical Health upon the Outcome of Admission to an Acute Psychogeriatrics Ward

Abstract

Objectives: To quantify the physical health of admissions to an acute psychogeriatric unit (PGU) and to determine whether measures of physical health predict psychiatric outcome at discharge and mortality at 12 months. Method: Prospective audit of PGU admissions over 12 months using the Physical Health Schema (PHS) to quantify physical health. Results: There were 88 admissions categorised into four principal psychiatric diagnostic groups: major depression (46), dementia (20), delirium (7) and ‘;other’ diagnoses (15). The mean number of organ systems affected by physical illness was 3.9 per admission (sd 1.5, range 1–8), which did not differ between psychiatric diagnostic groups. On the PHS, neurological disorders were the most severe and disabling conditions, with gastrointestinal and musculoskeletal disorders the other main acute conditions, and cardiovascular and sensory disorders the other main chronic conditions. Ratings of global outcome as recovered/improved were associated with significantly fewer chronic organ systems affected by physical illness than unchanged/worse outcomes (Model x2= 8.01, df = 1, P = 0.005) and ADL score (Model x2= 6.33, df = 1, P = 0.012). Mortality 12 months after discharge was predicted by PHS acute illness scores (Model x2= 7.94, df = 1, P < 0.005) and ADL score (Model x2= 6.43, df = 1, P < 0.05). Conclusion: Acute PGUs are best co‐located near geriatric medical wards in general hospitals due to high rates of physical illness.