Clinical Characteristics Of Inpatients Research Articles

First-admissions in Psychiatry: a cluster analysis of a sample of inpatients from 2019 to 2021

IntroductionOnly a few studies analyse the clinical and psychopathological characteristics of first-admitted inpatients regardless of diagnosis.ObjectivesDescribing the psychopathological, demographic, and clinical characteristics of inpatients with acute symptomatology identifying groups with common features using factors extracted from the Brief Psychiatric Rating Scale (BPRS).MethodsWe selected 103 (48 F) inpatients from the psychiatric ward of the Sant’Andrea Hospital in Rome from January 2019 to December 2021. We assessed psychopathological characteristics and suicide risk with BPRS, Global Assessment of Functioning, and Columbia-Suicide Severity Rating Scale and gathered the anamnestic and demographic data. We conducted descriptive analyses and factor analysis on BPRS items. Then we used the BPRS factors as variables to perform a cluster analysis.ResultsMajor Depressive Disorder (MDD) was the most frequent diagnosis. We obtained five factors: “Psychotic dimensions” (FI); “Anxiety” (FII); “Hostility and lack of cooperation” (FIII); “Depression” (FIV); “Flattening of affectivity” (FV). We identified two clusters (cluster 1 n=31; cluster 2 n=72). Patients in cluster 1 reported higher average scores in FI and FIII while the average scores of cluster 2 patients in FII and FIV were higher than patients in cluster 1. We called cluster 1 “psychotic and hostile patients compulsory admitted with a low risk of suicide”. Cluster 2 patients are “affective patients with a high risk of suicide”. The two clusters share an average age of 38-39 yo and an average GAF score indicating severe impairment and inability to function in almost all areas. They differ in the psychiatric diagnosis represented: respectively, Schizophrenia Spectrum Disorder and Bipolar Disorder with low suicidal risk, MDD, and Personality Disorders with a high suicidal risk. 39% of patients in cluster 1 were involuntarily admitted.ConclusionsThe results of our study show that patients admitted for the first time usually are admitted for psychotic symptoms and a high risk of suicide. Psychotic patients more often show hostility and lack of cooperativeness which can explain the higher rate of involuntary admissions. Patients with predominant affective symptoms show a higher risk of suicide. Our analyses do not consider categorical diagnosis highlighting that exist transdiagnostic groups of patients with specific needs.Disclosure of InterestNone Declared

A comparison of clinical characteristics of psychiatric inpatients in three hospitals from Western China and America

BackgroundDifferent countries have differences in social and cultural context and health system, which may affect the clinical characteristics of psychiatric inpatients. This study was the first to compare cross-cultural differences in the clinical characteristics of psychiatric inpatients in three hospitals from Western China and America.MethodsOverall, 905 and 1318 patients from three hospitals, one in America and two in Western China, respectively, were included. We used a standardised protocol and data collection procedure to record inpatients’ sociodemographic and clinical characteristics.ResultsSignificant differences were found between hospitals from the two countries. Positive symptoms were the main reason for admission in the Chinese hospitals, while reported suicide and self-injury symptoms more frequently led to hospital admission in America. Moreover, there were more inpatients with combined substance abuse in the American hospital (97.6% vs. 1.9%, P < 0.001). The length of stay (LOS) in America was generally shorter than in China (10.5 ± 11.9 vs. 20.7 ± 13.4, P < 0.001). The dosage of antipsychotic drugs used in the American hospital was higher than in China (275.1 ± 306.9 mg vs. 238.3 ± 212.5 mg, P = 0.002). Regression analysis showed that male sex, older age, retirees, being admitted because of physical symptoms, and using higher doses of antipsychotic drugs were significantly associated with longer hospitalisation in the American hospital (P < 0.05). Comparatively, patients who were divorced, experiencing suicidal ideation, admitted involuntarily, admitted because of physical, depression, or anxiety symptoms, and using higher doses of antipsychotic drugs had longer hospitalisation in Chinese hospitals (P < 0.05).ConclusionSignificant variations in clinical characteristics of inpatients were found between hospitals from Western China and America. The LOS in Chinese hospitals was significantly longer, but patients used higher doses of antipsychotic drugs in the American hospital. Admission due to physical symptoms and the use of higher dosage drugs were related to longer LOS in both countries.

Clinical Characteristicsof Inpatients With New-Onset Diabetes Mellitus in Eastern China: Based on Novel Clustering Analysis.

IntroductionThis study aimed to explore the novel classification of inpatients with new-onset diabetes in Eastern China by the cluster-based classification method and compare the clinical characteristics among the different subgroups.MethodsA total of 1017 Inpatients with new-onset diabetes of five hospitals in Eastern China were included in the study. Clustering analysis was used to cluster the data into five subgroups according to six basic variables. The differences in clinical characteristics, treatments, and the prevalence of diabetes-related diseases among the five subgroups were analyzed by multiple groups comparisons and pairwise comparisons. The risk of diabetes-related diseases in the five subgroups was compared by calculating odd ratio (OR). P value < 0.05 was considered significant.ResultsFive subgroups were obtained by clustering analysis with the highest proportion of patients with severe insulin-deficient diabetes (SIDD) 451 (44.35%), followed by patients with mild age-related diabetes (MARD) 236 (23.21%), patients with mild obesity-related diabetes (MOD) 207 (20.35%), patients with severe insulin-resistant diabetes (SIRD) 81 (7.96%), and patients with severe autoimmune diabetes (SAID) 42 (4.13%). Five subtypes had their own unique characteristics and treatments. The prevalence and risk of diabetes-related complications and comorbidities were also significantly different among the five subtypes. Diabetic kidney disease (DKD) was the most common in SIRD group. Patients in SIDD, SIRD, and MARD groups were more likely to develop cardiovascular disease (CVD) and/or stroke, diabetic peripheral vascular disease (DPVD), and diabetic distal symmetric polyneuropathy (DSPN). The prevalence and risk of metabolic syndrome (MS) were the highest in MOD and SIRD groups. Patients in SAID group had the highest prevalence and risk of diabetic ketoacidosis (DKA). Patients with MOD were more likely to develop non-alcoholic fatty liver disease (NAFLD).ConclusionsThe inpatients with new-onset diabetes in Eastern China had the unique clustering distribution. The clinical characteristics, treatments, and diabetes-related complications and comorbidities of the five subgroups were different, which may provide the basis for precise treatments of diabetes.

The Clinical Characteristics of Inpatients with AKI and the Risk Factors for Progression to CKD

The Clinical Characteristics of Inpatients with AKI and the Risk Factors for Progression to CKD

Clinical characteristics of inpatients with coronavirus disease 2019 (COVID-19) in Sichuan province

BackgroundThe outbreak of COVID-19 has resulted in serious concerns in China and abroad. To investigate clinical features of confirmed and suspected patients with COVID-19 in west China, and to examine differences between severe versus non-severe patients.MethodsPatients admitted for COVID-19 between January 21 and February 11 from fifteen hospitals in Sichuan Province, China were included. Experienced clinicians trained with methods abstracted data from medical records using pre-defined, pilot-tested forms. Clinical characteristics between severe and non-severe patients were compared.ResultsOf the 169 patients included, 147 were laboratory-confirmed, 22 were suspected. For confirmed cases, the most common symptoms from onset to admission were cough (70·7%), fever (70·5%) and sputum (33·3%), and the most common chest CT patterns were patchy or stripes shadowing (78·0%); throughout the course of disease, 19·0% had no fever, and 12·4% had no radiologic abnormality; twelve (8·2%) received mechanical ventilation, four (2·7%) were transferred to ICU, and no death occurred. Compared to non-severe cases, severe ones were more likely to have underlying comorbidities (62·5% vs 26·2%, P = 0·001), to present with cough (92·0% vs 66·4%, P = 0·02), sputum (60·0% vs 27·9%, P = 0·004) and shortness of breath (40·0% vs 8·2%, P < 0·0001), and to have more frequent lymphopenia (79·2% vs 43·7%, P = 0·003) and eosinopenia (84·2% vs 57·0%, P = 0·046).ConclusionsThe symptoms of patients in west China were relatively mild, and an appreciable proportion of infected cases had no fever, warranting special attention.

Clinical Characteristics of Inpatients with Coronavirus Disease 2019 and Acute Ischemic Stroke: From Epidemiology to Outcomes

Clinical Characteristics of Inpatients with Coronavirus Disease 2019 and Acute Ischemic Stroke: From Epidemiology to Outcomes

Clinical Characteristics of Inpatients with Coronavirus Disease 2019 and Acute Ischemic Stroke: From Epidemiology to Outcomes.

Acute Ischemic Stroke (AIS) is currently the most frequently reported neurological complication of Coronavirus disease 2019 (COVID-19). This article will elaborate the clinical features of inpatients with COVID-19 and AIS and the pathophysiological mechanism of AIS under the background of COVID-19. Through a detailed search of relevant studies, we found that the incidence of AIS among COVID-19 patients varied from 0.9% to 4.6%, and AIS has been observed in many people without an underlying disease and cardiovascular risk factors as well as young people. The National Institute of Health Stroke Scale (NIHSS) score of COVID-19 patients with AIS was higher than historical AIS patients, and the proportion of large vessel occlusion (LVO) was about 64.2%. COVID-19 patients with AIS generally have high levels of D-D dimer, fibrinogen, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), suggesting systemic hyperinflammatory and hypercoagulable state. The pooled mortality of COVID-19 patients with AIS was 38% and the mortality of LVO patients is higher (45.9%). Compared with COVID-19-negative AIS patients in the same period in 2020 and 2019, COVID-19 patients with AIS had a worse prognosis.

Factors Associated to the Onset of Mental Illness Among Hospitalized Migrants to Italy: A Chart Review.

Migration is a complex phenomenon and mental illness among immigrants remains a major matter of concern in Italy and worldwide. 243 medical and pharmacy records of patients admitted to University of Foggia hospital between 2004 and 2018 were retrospectively screened and included in the study. Socio-demographic data and clinical characteristics of inpatients were compared in those with and without first-episode of mental illness (FEMI). Subjects (140 men, 103 women; aged 34.4 ± 10.2 years) represented 6.66 ± 3.73% of all hospitalizations in 15 years. Nearly half of them (48.5%) had emigrated from other European countries. 30.8% were diagnosed with a DSM-IV TR unspecified psychosis. 103 patients (42.3%) were in first-lifetime episodes of mental illness. Factors significantly associated with FEMI were: younger age, sex (men), immigrating from Africa, poor language proficiency, lower amount of prescribed psychotropics. Mental health among immigrants is of major concern in Italy. Our findings report on factors possibly associated to the onset of mental illness among immigrant psychiatric inpatients.

Chest Computed Tomography and Clinical Follow-Up of Discharged Patients with COVID-19 in Wenzhou City, Zhejiang, China.

Rationale: Many clinical studies have focused on the epidemiological and clinical characteristics of inpatients with coronavirus disease (COVID-19). However, there are few reports about the clinical follow-up of discharged patients.Objectives: To describe the follow-up of patients with COVID-19 in Wenzhou City, Zhejiang, China.Methods: We retrospectively reviewed 4-week follow-ups in patients with COVID-19, including computed tomographic (CT) chest scanning, blood testing, and oropharyngeal-swab testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid. The chest CT scans and blood tests were performed on the last day before discharge and 2 weeks and 4 weeks after discharge. The oropharyngeal-swab tests were performed at both 1 week and 2 weeks after discharge. Fifty-one patients with common COVID-19 were enrolled in the study. All the CT and clinical data were collected between January 23 and March 28, 2020.Results: Compared with the abnormalities found on the the last CT scans before discharge, the abnormalities in the lungs at the first and second follow-ups after discharge had been gradually absorbed. The cases with focal ground-glass opacity were reduced from 17.7% to 9.8% of cases. The cases with multiple ground-glass opacities decreased from 80.4% to 23.5%. The cases with consolidation were reduced from 49.0% to 2.0%. The cases with interlobular septal thickening were reduced from 80.4% to 35.3%. The cases with subpleural lines were reduced from 29.4% to 7.8%. The cases with irregular lines were reduced from 41.2% to 15.7%. The lung lesions of 25.5% patients were shown to be fully absorbed on the first CT scans after discharge, and the rate of lung recovery increased to 64.7% after the second follow-up. Nucleic-acid test results became recurrently positive in 17.6% of discharged patients, of whom only 33.3% complained of clinical symptoms. There were no differences in the characteristics of the last CT scans before discharge between the patients with recurrently positive test results and the patients with negative test results. The lung damage was fully absorbed in 55.6% of discharged patients with recurrence of positive test results for SARS-CoV-2 ribonucleic acid.Conclusions: The lung damage due to COVID-19 could be reversible for patients with common COVID-19. A few cases showed recurring positive results of nucleic-acid tests after discharge.

Clinical Characteristics of Inpatients with Coronavirus Disease 2019 and Acute Ischemic Stroke: From Epidemiology to Outcomes

Clinical Characteristics of Inpatients with Coronavirus Disease 2019 and Acute Ischemic Stroke: From Epidemiology to Outcomes

Clinical Characteristics of Inpatients with Childhood vs. Adolescent Anorexia Nervosa.

We aimed to compare the clinical data at first presentation to inpatient treatment of children (<14 years) vs. adolescents (≥14 years) with anorexia nervosa (AN), focusing on duration of illness before hospital admission and body mass index (BMI) at admission and discharge, proven predictors of the outcomes of adolescent AN. Clinical data at first admission and at discharge in 289 inpatients with AN (children: n = 72; adolescents: n = 217) from a German multicenter, web-based registry for consecutively enrolled patients with childhood and adolescent AN were analyzed. Inclusion criteria were a maximum age of 18 years, first inpatient treatment due to AN, and a BMI <10th BMI percentile at admission. Compared to adolescents, children with AN had a shorter duration of illness before admission (median: 6.0 months vs. 8.0 months, p = 0.004) and higher BMI percentiles at admission (median: 0.7 vs. 0.2, p = 0.004) as well as at discharge (median: 19.3 vs. 15.1, p = 0.011). Thus, in our study, children with AN exhibited clinical characteristics that have been associated with better outcomes, including higher admission and discharge BMI percentile. Future studies should examine whether these factors are actually associated with positive long-term outcomes in children.

The clinical study of inpatients with ocular trauma in Spring Festival during 8 consecutive years

Objective To analyse the clinical characteristics of inpatients with ocular trauma in Spring Festival during 8 consecutive years. Methods The data of 138 inpatients with ocular trauma in Spring Festival during 2011-2018 were analyzed retrospectively. The age distribution, injury causes, time from injury to treatment, types of trauma and efficacy of treament were analyzed. Results There were 1 436 inpatients during 8 consecutive years, and among them 138 patients (9.61%) with ocular trauma were analyzed. There were 126 monocular patients(91.3%) and 12 binocular patients(8.70%). There were 108 males(78.26%) and 30 females(21.74%). The age range was 4-85 years, with average of (50.26±17.24)years. Fireworks and crackers were the main cause of ocular trauma in 43 cases(31.16%). The high-risk age group was 18-44 years. The visual acuity<0.05 was blind in 68 eyes (45.33%) before treatment and 30 eyes(20.00%)after treatment. Two eyes (1.33%) underwent enucleation. Conclusion Fireworks and crackers are the main causes of ocular trauma in Spring Festival. The high-risk age group is 18-44 years. Ocular trauma is great harm to visual function. Key words: Trauma, ocular; Spring Festival; Analysis, clinical

Sociodemographic and Clinical Characteristics of Inpatients with Schizophrenia In Psychiatry Clinics

Sociodemographic and Clinical Characteristics of Inpatients with Schizophrenia In Psychiatry Clinics

Clinical characteristics and nursing strategies of 35 inpatients with skin tears

Objective To analyze the clinical characteristics of inpatients with skin tears and to explore corresponding nursing strategies. Methods A data collection form was developed to collect data of the 35 patients with skin tears by retrospective analysis, including their age, gender, underlying diseases, nutritional status, department, location and severity level, activity ability, consciousness level and nursing measures, with the results analyzed by descriptive statistics. Results Out of the 35 patients, male accounted for 57.1% (20/35), with average age of (68.5±0.8) years old, and 74.3% (26/35) equal to or above 65 years old. Characteristics of skin tears (with locations included): lower extremities and trunk were the most, both accounted for 28.6% (10/35), followed by upper limbs, accounting for 14.3% (5/35), hands and feet, both accounting for 11.4% (4/35), and the least of head and face, accounting for 5.7% (2/35). Severity of skin tears: Grade-3 was the most, accounting for 42.9% (15/35), followed by Grade-2b, accounting for 25.6% (9/35), Grade-1b, accounting for 14.3% (5/35), and Grade-1a and Grade-2a, both accounting for 8.6% (3/35). Clinical characteristics: those with activity slightly limited accounted for 51.4% (18/35), followed by those with activity very much limited, accounting for 28.6% (10/35), with no limitation, accounting for 14.3% (5/35), and completely limited, accounting for 5.7% (2/35). Consciousness level: Conscious patients accounted for 80% (28/35), and unconscious ones 20% (7/35). Preventive nursing measures were taken only by 20% (7/35). Conclusions The majority of inpatients with skin tears are with slight limitation of activity, conscious minds, and old age. Implementation rate of preventive measures is very low. It is advised to strengthen training of nurses, improve awareness of prevention, pay more attention to patients with high risk of skin tears and improve the implementation rate of preventive measures. Key words: Nursing; Skin tears; Clinical characteristics

Overt Hypothyroidism in Hospitalized Patients: Clinical Characteristics

Objectives: Hypothyroidism is usually detected in an outpatient setting, but might be diagnosed during hospitalization. The prevalent symptoms are not fully defined. This study aimed to determine the clinical characteristics of in-patients with overt hypothyroidism. Methods: The medical records of 23 inpatients (16F/7M, age 61.5 ± 21.8 years), who had 29 admissions with a primary diagnosis of hypothyroidism from January 1997 to December 2007 were retrospectively reviewed. They comprised 0.01% of all adult medical admissions during the study. Results: Fifty-five percent had a pre-admission diagnosis of hypothyroidism, 10% were nursing home residents and 38% had cognitive decline. Sixtynine percent presented with multiple complaints, mostly weakness and constipation, reported by 89% and 68%, respectively. Thyrotropin level was 74.3 ± 53.5 mIU/L (normal 0.23 - 4) and free thyroxine was 0.43 ± 0.29 ng/dL (normal 0.8 - 2). Elevated creatinine phosphokinase, anemia (hemoglobin 12 g/dL) and hyponatremia (sodium 135 mEq/L) were present in 89%, 62%, and 13%, respectively. Conclusions: Overt hypothyroidism during hospitalization occurs infrequently and mostly in patients with previously diagnosed hypothyroidism. Clinical manifestations include multiple non-specific symptoms, mainly weakness and constipation, while typical “hypothyroid” symptoms such as cold intolerance and weight gain are often overlooked. A high index of suspicion is needed to detect hypothyroidism in the hospital setting.

Analysis on Elderly Inpatients with Infectious Keratitis: Causative Organisms, Clinical Aspects, and Risk Factors

Purpose: To investigate the epidemiological, microbiological, and clinical characteristics of inpatients with infectious keratitis and also to elucidate risk factors for unimproved visual outcomes. Methods: We performed a retrospective chart review of 167 eyes in 167 patients with infectious keratitis hospitalized between January 2005 and December 2007 at Yeungnam University Hospital. Results: Keratitis cases were classified into four groups according to etiology: 92 bacterial, 43 herpes virus, 31 fungal, and 1 acanthamoeba. Culture positivity was 44.6% in bacterial keratitis and 22.6% in fungal keratitis, and KOH positivity of fungus was 48.4%. Of all the 55 isolated pathogens, the most commonly isolated microorganisms were S. epidermidis in Gram-positive bacteria, P. aeruginosa in Gram-negative bacteria, and Candida species in fungus. Epidemiologic characteristics such as male gender (59.9%), an age in the seventh decade (24.6%), farming occupation (40.1%), and trauma with vegetable matter (42.5%) were noted. Many fungal and bacterial keratitis cases were characterized by inadequate use of topical steroid when patients initially presented to our clinic. Visual outcomes were poorer in fungal keratitis than they were in other forms of keratitis. Conclusions: Risk factors for unimproved visual outcomes included an ulcer exceeding 3 mm in size and a fungal source. Therefore, a strong effort should be made to discern a differential diagnosis in infectious keratitis and to determine the appropriate early treatment for a successful treatment outcome.

P8 To study the demographic and clinical characteristics of in-patients with idiopathic inflammatory myositis

P8 To study the demographic and clinical characteristics of in-patients with idiopathic inflammatory myositis

Clinical Characteristics of Inpatients with Depression

Clinical Characteristics of Inpatients with Depression