Elevated Blood Urea Nitrogen and Medical Outcome of Psychiatric Inpatients.
In: Psychiatric Quarterly, Jg. 85 (2014-03-01), Heft 1, S. 111-120
Online
academicJournal
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 (BUN >25 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 ( p < 0.0001). 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 BUN >25 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. [ABSTRACT FROM AUTHOR]
Titel: |
Elevated Blood Urea Nitrogen and Medical Outcome of Psychiatric Inpatients.
|
---|---|
Autor/in / Beteiligte Person: | Manu, Peter ; Al-Dhaher, Zainab ; Khan, Sameer ; Kane, John ; Correll, Christoph |
Link: | |
Zeitschrift: | Psychiatric Quarterly, Jg. 85 (2014-03-01), Heft 1, S. 111-120 |
Veröffentlichung: | 2014 |
Medientyp: | academicJournal |
ISSN: | 0033-2720 (print) |
DOI: | 10.1007/s11126-013-9274-2 |
Schlagwort: |
|
Sonstiges: |
|