Elevated Blood Urea Nitrogen and Medical Outcome of Psychiatric Inpatients
In: Psychiatric Quarterly, Jg. 85 (2013-10-18), S. 111-120
Online
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Zugriff:
Elevated blood urea nitrogen (BUN) is associated with increased severity of illness and mortality, but its predictive value has not been studied in patients admitted to free-standing psychiatric hospitals. To determine the clinical outcome of psychiatric inpatients with elevated BUN on admission and to create a quantitative method of using BUN for predicting deteriorations requiring transfers of psychiatric inpatients to a general hospital we conducted a retrospective cohort study of 939 adults consecutively admitted to a free-standing psychiatric hospital in 2010. Transfer to a general hospital was used as a proxy marker for poor medical outcome. The score Age (years) plus BUN (mg/dL) was used in sensitivity analyses to identify patients with medical deterioration in derivation (N = 523) and validation (N = 414) samples. Fifty-two (5.5%) patients had admission azotemia (BUN25 mg/dL). Medical deteriorations requiring emergency transfer to a general hospital occurred in 24 (46.2%; 95% confidence interval = 32.6-49.8%) of azotemic patients and 112 (12.6%; 95% confidence interval = 10.4-14.8%) of those with normal BUN (p0.0001). Age + BUN ≥ 90 identified 51 transferred patients and had positive and negative predictive values of 39.8 and 89.5%, respectively, in the entire sample. We conclude that psychiatric inpatients with BUN25 mg/dL or Age + BUN ≥ 90 are at risk for medical deterioration. Free-standing psychiatric hospitals should develop models of care requiring frequent, scheduled medical follow-up and enhanced monitoring for this vulnerable populations.
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Elevated Blood Urea Nitrogen and Medical Outcome of Psychiatric Inpatients
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Autor/in / Beteiligte Person: | Kane, John M. ; Correll, Christoph U. ; Al-Dhaher, Zainab ; Khan, Sameer ; Manu, Peter |
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Zeitschrift: | Psychiatric Quarterly, Jg. 85 (2013-10-18), S. 111-120 |
Veröffentlichung: | Springer Science and Business Media LLC, 2013 |
Medientyp: | unknown |
ISSN: | 1573-6709 (print) ; 0033-2720 (print) |
DOI: | 10.1007/s11126-013-9274-2 |
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