TY - JOUR
T1 - Analysis of risk factors and outcomes in psychiatric inpatients with tardive dyskinesia
T2 - A nationwide case-control study
AU - Patel, Rikinkumar S.
AU - Mansuri, Zeeshan
AU - Chopra, Amit
N1 - Funding Information:
To compare the differences in psychiatric hospitalization outcomes of patients with and without TD, the outcome variables of interest included the severity of illness that measures the loss of body functions, LOS, total charges, and disposition of patient. The All Patient Refined DRGs (APR-DRGs) and 3M Health Information Systems software were used to measure the severity of illness subclass (“ NIS Description of Data Elements. Healthcare Cost and Utilization Project (HCUP).,” 2017). In the NIS, we defined the LOS as the number of nights the patient was hospitalized for a particular primary diagnosis (DX1) (“ NIS Description of Data Elements. Healthcare Cost and Utilization Project (HCUP).,” 2017). Total charges does not include professional fees and non-covered charges. If the source provided total charges with professional fees, then these fees were removed from the charges during data processing (“NIS Description of Data Elements. Healthcare Cost and Utilization Project (HCUP).,” 2017).
Publisher Copyright:
© 2019
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/5
Y1 - 2019/5
N2 - Objective: To analyze comorbidities and outcomes in patients with tardive dyskinesia (TD) during psychiatric inpatient management. Methods: We conducted a case-control study using the Nationwide Inpatient Sample. It included 77,022 adult inpatient admissions for mood disorders and schizophrenia. Cases had a secondary diagnosis of TD, and controls without TD were matched for age. Multivariable logistic regression was used to generate odds ratio (OR). Results: Majority of TD patients were older age adults (50–64 years; 40%), and were in nearly equal proportions of men and women. African Americans had two-fold higher odds of TD. TD patients had a higher likelihood for cardio-metabolic comorbidities-obesity (OR 1.61, 95% CI 1.481–1.756), hypertension (OR 1.78, 95% CI 1.635–1.930) and diabetes (OR 1.54, 95% CI 1.414–1.680) compared to controls. They also had 1.5-fold increased risk of comorbid drug abuse. Patients with schizophrenia and bipolar disorder (depressive) had four-fold higher odds of TD. TD patients had about six-fold higher odds of severe morbidity. They had a higher likelihood of extended hospitalization stay by 6.36 days (95% CI 6.174–6.550) and higher cost by $20,415 (95% CI 19537–21293) compared to controls. Conclusion: Psychiatric inpatients with TD have greater severity of illness, and those with schizophrenia and bipolar disorders are at highest risk. Presence of TD portends poor hospital outcomes and need for higher acute inpatient care.
AB - Objective: To analyze comorbidities and outcomes in patients with tardive dyskinesia (TD) during psychiatric inpatient management. Methods: We conducted a case-control study using the Nationwide Inpatient Sample. It included 77,022 adult inpatient admissions for mood disorders and schizophrenia. Cases had a secondary diagnosis of TD, and controls without TD were matched for age. Multivariable logistic regression was used to generate odds ratio (OR). Results: Majority of TD patients were older age adults (50–64 years; 40%), and were in nearly equal proportions of men and women. African Americans had two-fold higher odds of TD. TD patients had a higher likelihood for cardio-metabolic comorbidities-obesity (OR 1.61, 95% CI 1.481–1.756), hypertension (OR 1.78, 95% CI 1.635–1.930) and diabetes (OR 1.54, 95% CI 1.414–1.680) compared to controls. They also had 1.5-fold increased risk of comorbid drug abuse. Patients with schizophrenia and bipolar disorder (depressive) had four-fold higher odds of TD. TD patients had about six-fold higher odds of severe morbidity. They had a higher likelihood of extended hospitalization stay by 6.36 days (95% CI 6.174–6.550) and higher cost by $20,415 (95% CI 19537–21293) compared to controls. Conclusion: Psychiatric inpatients with TD have greater severity of illness, and those with schizophrenia and bipolar disorders are at highest risk. Presence of TD portends poor hospital outcomes and need for higher acute inpatient care.
KW - Psychiatry
UR - http://www.scopus.com/inward/record.url?scp=85065765437&partnerID=8YFLogxK
U2 - 10.1016/j.heliyon.2019.e01745
DO - 10.1016/j.heliyon.2019.e01745
M3 - Article
AN - SCOPUS:85065765437
SN - 2405-8440
VL - 5
JO - Heliyon
JF - Heliyon
IS - 5
M1 - e01745
ER -