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Depression is independently associated with increased length of stay and readmissions in multimorbid inpatients


Beeler, Patrick E; Cheetham, Marcus; Held, Ulrike; Battegay, Edouard (2020). Depression is independently associated with increased length of stay and readmissions in multimorbid inpatients. European Journal of Internal Medicine, 73:59-66.

Abstract

Little is known about the impact of depression across a broad range of multimorbid patients hospitalized for reasons other than depression. The objective of the study was to investigate in a large sample of multimorbid inpatients whether ancillary depression is associated with increased length of stay (LOS) and readmissions, two important clinical outcomes with implications for healthcare utilization and costs.

METHODS: We retrospectively analyzed a cohort of 253,009 multimorbid inpatients aged ≥18 at an academic medical center, 8/2009-8/2017.
PRIMARY OUTCOME: LOS.
SECONDARY OUTCOMES: LOS related to different main diagnoses, readmissions within 1, 3, 6, 12, and 24-months after discharge.
RESULTS: Multivariable linear regression showed 24% longer LOS in patients with ancillary depression (1.24; 95% confidence interval [CI]: 1.22, 1.25). Females stayed 22% longer (1.22; 95% CI: 1.20, 1.25), males 24% (1.24; 95% CI: 1.22, 1.27). We identified 16 main diagnosis clusters in which ancillary depression was associated with significant LOS increases, with associations being strongest for "Failure and rejection of transplanted organs and tissues", "Other noninfective gastroenteritis and colitis", and "Other soft tissue disorders, not elsewhere classified". Multivariable logistic and Poisson regression showed independent associations of ancillary depression with increased readmission odds and frequencies at 1, 3, 6, 12, and 24 months.
CONCLUSIONS: Ancillary depression was independently associated with increased LOS and more readmissions across a broad range of multimorbid inpatients.

Abstract

Little is known about the impact of depression across a broad range of multimorbid patients hospitalized for reasons other than depression. The objective of the study was to investigate in a large sample of multimorbid inpatients whether ancillary depression is associated with increased length of stay (LOS) and readmissions, two important clinical outcomes with implications for healthcare utilization and costs.

METHODS: We retrospectively analyzed a cohort of 253,009 multimorbid inpatients aged ≥18 at an academic medical center, 8/2009-8/2017.
PRIMARY OUTCOME: LOS.
SECONDARY OUTCOMES: LOS related to different main diagnoses, readmissions within 1, 3, 6, 12, and 24-months after discharge.
RESULTS: Multivariable linear regression showed 24% longer LOS in patients with ancillary depression (1.24; 95% confidence interval [CI]: 1.22, 1.25). Females stayed 22% longer (1.22; 95% CI: 1.20, 1.25), males 24% (1.24; 95% CI: 1.22, 1.27). We identified 16 main diagnosis clusters in which ancillary depression was associated with significant LOS increases, with associations being strongest for "Failure and rejection of transplanted organs and tissues", "Other noninfective gastroenteritis and colitis", and "Other soft tissue disorders, not elsewhere classified". Multivariable logistic and Poisson regression showed independent associations of ancillary depression with increased readmission odds and frequencies at 1, 3, 6, 12, and 24 months.
CONCLUSIONS: Ancillary depression was independently associated with increased LOS and more readmissions across a broad range of multimorbid inpatients.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic and Policlinic for Internal Medicine
04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
04 Faculty of Medicine > Center of Competence Multimorbidity
08 Research Priority Programs > Dynamics of Healthy Aging
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Internal Medicine
Language:English
Date:1 March 2020
Deposited On:09 Dec 2019 14:41
Last Modified:28 Feb 2020 02:04
Publisher:Elsevier
ISSN:0953-6205
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.ejim.2019.11.012
PubMed ID:31791574

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