hrvatski

Uzroci i dinamika tjelesnih komplikacija/neželjenih događaja tijekom hospitalizacije bolesnika s demencijom / The frequency and causes of physical complications/adverse events during the hospitalization of patients with dementia

Uvod: Osobe s demencijom osjetljivije su na razvoj različitih komplikacija/neželjenih događaja u odnosu na osobe iste dobne skupine bez demencije. Češće se zaprimaju u bolnicu, gdje imaju veću prevalenciju komplikacija i povećanu smrtnost. Cilj: ispitati učestalost hitnih premještaja bolesnika s demencijom zbog tjelesnih komplikacija iz Klinike za psihijatriju Vrapče na somatske odjele drugih bolnica. Metode: U ovom retrospektivnom istraživanju analizirali smo podatke bolesnika s demencijom koji su liječeni od 1. siječnja do 31. kolovoza 2019. godine na Odjelu psihogerijatrije u Klinici za psihijatriju Vrapče s naglaskom na vrijeme trajanja hospitalizacije i razloge otpusta koji su doveli do premještaja s Odjela. Rezultati: Od siječnja do kraja kolovoza 2019. godine na Odjel psihogerijatrije u Klinici zaprimljeno je ukupno 256 bolesnika (67, 97 % žena i 32, 03 % muškaraca). Prosječna dob žena bila je 80, 5, a muškaraca 76, 4 godina. Premješteno na somatski odjel (bolnicu) bilo je 28 % bolesnika (40, 24 % muškaraca, 23 % žena), a od toga 39 % u prvih sedam dana od dolaska u bolnicu. Pneumonija je bila vodeća somatska dijagnoza kod 19 % premještenih. Prosječno trajanje hospitalizacije među svim ispitanicima bilo je kod muškaraca 33, 08 dana, a kod žena 36, 47 dana. U istom je razdoblju na Odjelu preminulo 10, 93 % bolesnika (12, 2 % muškaraca i 10, 34 % žena), od toga 25 % unutar pet dana od dolaska u bolnicu. Zbog neujednačenosti pisanja redoslijeda otpusnih dijagnoza, za detaljniju analizu razloga premještaja, bit će potrebno podrobnije ispitivanje. Zaključak: Najteža tjelesna pogoršanja i smrtni ishodi javljali su se u prvih tjedan dana od dolaska u bolnicu. Rezultati ukazuju na nužnost somatske obrade i liječenja bolesnika s demencijom prije nego budu hospitalizirani na psihijatrijskom odjelu. / Introduction: Patients with dementia are more susceptible to the development of various complications/adverse events than people of the same age group without dementia. They are more often admitted to hospitals, where they have a higher prevalence of complications and higher mortality. Aim: To examine the frequency of physical complications that require emergency transfers of patients with dementia from the psychogeriatric ward of the University Psychiatric Hospital Vrapče (UPHV) to somatic wards of other hospitals. Patients and methods: In this retrospective study we analysed the data of patients with dementia who received medical treatment at the psychogeriatric ward of the University Psychiatric Hospital Vrapče between 1 January and 31 August 2019, with special emphasis on the treatment length and reasons for discharge due to compromised medical condition. Results: 256 patients (67.97% female, 32.03% male) were admitted to the psychogeriatric ward of the UPHV. The average age was 80.5 years for female and 76.4 years for male patients. 28% of patients (23% of all female and 40.24% of all male patients) were transferred to somatic wards of other hospitals. 39% of all transferred patients were transferred within the first seven days after the admission to the UPHV. Pneumonia was the main somatic diagnosis among 19% of all transferred patients. The mean duration of hospitalization was 36.47 days for female patients and 33.08 days for male patients. 10.93% of all admitted patients (10.34% of all female and 12.2% of all male patients) died at the psychogeriatric ward, 25% of whom died within the first five days after the admission to the UPHV. Due to a lack of uniform order of registering diagnoses, a more detailed examination of reasons for transfers will be required. Conclusion: The most severe deteriorations in the physical condition and fatal outcomes occurred within the first week after the admission to the UPHV. The results indicate the necessity of somatic treatment of dementia patients before admission to a psychiatric ward.

dementia ; komorbiditet ; hitni premještaj ; komplikacije ; smrtnost

Rad je objavljen u Tematskom broju časopisa Socijalna psihijatrija a koji je popratio Simpozij povodom 140. obljetnice Bolnice Vrapče održan 15.11.2019. godine.

engleski

The frequency and causes of physical complications/adverse events during the hospitalization of patients with dementia

Uvod: Osobe s demencijom osjetljivije su na razvoj različitih komplikacija/neželjenih događaja u odnosu na osobe iste dobne skupine bez demencije. Češće se zaprimaju u bolnicu, gdje imaju veću prevalenciju komplikacija i povećanu smrtnost. Cilj: ispitati učestalost hitnih premještaja bolesnika s demencijom zbog tjelesnih komplikacija iz Klinike za psihijatriju Vrapče na somatske odjele drugih bolnica. Metode: U ovom retrospektivnom istraživanju analizirali smo podatke bolesnika s demencijom koji su liječeni od 1. siječnja do 31. kolovoza 2019. godine na Odjelu psihogerijatrije u Klinici za psihijatriju Vrapče s naglaskom na vrijeme trajanja hospitalizacije i razloge otpusta koji su doveli do premještaja s Odjela. Rezultati: Od siječnja do kraja kolovoza 2019. godine na Odjel psihogerijatrije u Klinici zaprimljeno je ukupno 256 bolesnika (67, 97 % žena i 32, 03 % muškaraca). Prosječna dob žena bila je 80, 5, a muškaraca 76, 4 godina. Premješteno na somatski odjel (bolnicu) bilo je 28 % bolesnika (40, 24 % muškaraca, 23 % žena), a od toga 39 % u prvih sedam dana od dolaska u bolnicu. Pneumonija je bila vodeća somatska dijagnoza kod 19 % premještenih. Prosječno trajanje hospitalizacije među svim ispitanicima bilo je kod muškaraca 33, 08 dana, a kod žena 36, 47 dana. U istom je razdoblju na Odjelu preminulo 10, 93 % bolesnika (12, 2 % muškaraca i 10, 34 % žena), od toga 25 % unutar pet dana od dolaska u bolnicu. Zbog neujednačenosti pisanja redoslijeda otpusnih dijagnoza, za detaljniju analizu razloga premještaja, bit će potrebno podrobnije ispitivanje. Zaključak: Najteža tjelesna pogoršanja i smrtni ishodi javljali su se u prvih tjedan dana od dolaska u bolnicu. Rezultati ukazuju na nužnost somatske obrade i liječenja bolesnika s demencijom prije nego budu hospitalizirani na psihijatrijskom odjelu. / Introduction: Patients with dementia are more susceptible to the development of various complications/adverse events than people of the same age group without dementia. They are more often admitted to hospitals, where they have a higher prevalence of complications and higher mortality. Aim: To examine the frequency of physical complications that require emergency transfers of patients with dementia from the psychogeriatric ward of the University Psychiatric Hospital Vrapče (UPHV) to somatic wards of other hospitals. Patients and methods: In this retrospective study we analysed the data of patients with dementia who received medical treatment at the psychogeriatric ward of the University Psychiatric Hospital Vrapče between 1 January and 31 August 2019, with special emphasis on the treatment length and reasons for discharge due to compromised medical condition. Results: 256 patients (67.97% female, 32.03% male) were admitted to the psychogeriatric ward of the UPHV. The average age was 80.5 years for female and 76.4 years for male patients. 28% of patients (23% of all female and 40.24% of all male patients) were transferred to somatic wards of other hospitals. 39% of all transferred patients were transferred within the first seven days after the admission to the UPHV. Pneumonia was the main somatic diagnosis among 19% of all transferred patients. The mean duration of hospitalization was 36.47 days for female patients and 33.08 days for male patients. 10.93% of all admitted patients (10.34% of all female and 12.2% of all male patients) died at the psychogeriatric ward, 25% of whom died within the first five days after the admission to the UPHV. Due to a lack of uniform order of registering diagnoses, a more detailed examination of reasons for transfers will be required. Conclusion: The most severe deteriorations in the physical condition and fatal outcomes occurred within the first week after the admission to the UPHV. The results indicate the necessity of somatic treatment of dementia patients before admission to a psychiatric ward.

dementia ; comorbidity ; emergency transfer ; complications ; mortality

Rad je objavljen u Tematskom broju časopisa Socijalna psihijatrija a koji je popratio Simpozij povodom 140. obljetnice Bolnice Vrapče održan 15.11.2019. godine.