Abstract
Background
Heart failure (HF) is a major healthcare problem contributing significantly to hospital
admission stays and National Health Service (NHS) spending. Reducing length of hospital
stay (LoS) in HF is paramount in reducing this burden and is influenced by factors
relating to the condition, sociodemographics and comorbidities. Psychiatric comorbidities
are being increasingly identified amongst HF patients but their impact on LoS has
not been studied in the UK.
Methods
We investigated the impact of psychiatric comorbidities on LoS amongst 31,760 HF patients
admitted to hospitals in North England between 1st January 2000 and 31st March 2013
from the ACALM (Algorithm for Comorbidities, Associations, Length of stay and Mortality)
study. The ACALM protocol uses ICD-10 and OPCS-4 coding to trace HF patients, psychiatric
comorbidities and demographics including LoS.
Results
Amongst 31,760 HF patients mean LoS in the absence of psychiatric comorbidities was
11.2 days. The presence of a psychiatric comorbidity increased LoS by 3.3 days. Logistic regression accounting for age, gender and ethnicity showed that LoS
was significantly longer in patients suffering from depression (3.4 days, p < 0.001), bipolar disorder (8.8 days, p < 0.001) and all types of dementia (4.2 days, p < 0.001).
Conclusions
Our results demonstrate that psychiatric comorbidities have a significant and clinically
important impact on LoS in HF patients in the UK. Clinicians should be actively aware
of psychiatric conditions amongst HF patients and manage them to reduce LoS and ultimately
the risk for patients and financial burden for the NHS.
Keywords
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Article info
Publication history
Published online: January 08, 2016
Accepted:
January 5,
2016
Received in revised form:
December 11,
2015
Received:
August 31,
2015
Identification
Copyright
© 2016 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
