Predictors of 30-day rehospitalization in a sample of hospitalized patients with Bipolar I disorder

Bozzay, Melanie L.; Gaudiano, Brandon A.; Arias, Sarah A.; Epstein‐Lubow, Gary; Miller, Ivan W.; Weinstock, Lauren M.

doi:10.1016/j.psychres.2019.112559

Cited by 3 publications

(3 citation statements)

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“…In a real-world Japanese clinical setting, we found that 3.06% of outpatients with bipolar disorder experienced psychiatric hospitalization over the course of the year after baseline. This proportion was lower than observed in previous studies examining predictors of rehospitalization of patients with bipolar disorder ( 9 , 10 ). Our study participants were likely at relatively low risk of hospitalization because they included patients with no previous hospitalizations.…”

Section: Discussioncontrasting

confidence: 74%

“…A recent study has shown that the clinical course is a predictor of functional recovery, particularly that a high number of hospitalizations and being manic at baseline are predictors of subsequent worsening of functional impairment ( 7 ). In addition, concomitant use of psychotropic medications other than mood stabilizers has been found to be statistically significant as a predictor of both long-term hospitalization ( 8 ) and early readmission ( 9 ) in patients with bipolar disorder. On the other hand, a 1-year naturalistic cohort study at a single institution found no association between rehospitalization and any type of drug regimen, suggesting the equal effectiveness of individually optimized pharmacotherapy regimens for patients with bipolar disorder ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

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Predictors of psychiatric hospitalization among outpatients with bipolar disorder in the real-world clinical setting

Tokumitsu

Yasui‐Furukori

Adachi³

et al. 2023

Front. Psychiatry

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BackgroundBipolar disorder is a psychiatric disorder that causes recurrent manic and depressive episodes, leading to decreased levels of social functioning and suicide. Patients who require hospitalization due to exacerbation of bipolar disorder have been reported to subsequently have poor psychosocial functioning, and so there is a need to prevent hospitalization. On the other hand, there is a lack of evidence regarding predictors of hospitalization in real-world clinical practice.MethodsThe multicenter treatment survey on bipolar disorder (MUSUBI) in Japanese psychiatric clinics was an observational study conducted to provide evidence regarding bipolar disorder in real-world clinical practice. Psychiatrists were asked, as part of a retrospective medical record survey, to fill out a questionnaire about patients with bipolar disorder who visited 176 member clinics of the Japanese Association of Neuro-Psychiatric Clinics. Our study extracted baseline patient characteristics from records dated between September and October 2016, including comorbidities, mental status, duration of treatment, Global Assessment of Functioning (GAF) score, and pharmacological treatment details. The incidence and predictors of hospitalization among patients with bipolar disorder over a 1-year period extending from that baseline to September–October 2017 were examined.ResultsIn total, 2,389 participants were included in our study, 3.06% of whom experienced psychiatric hospitalization over the course of 1 year from baseline. Binomial logistic regression analysis revealed that the presence of psychiatric hospitalization was correlated with bipolar I disorder, lower baseline GAF scores, unemployment, substance abuse and manic state.ConclusionsOur study revealed that 3.06% of outpatients with bipolar disorder were subjected to psychiatric hospitalization during a 1-year period that extended to September–October 2017. Our study suggested that bipolar I disorder, lower baseline GAF scores, unemployment, substance abuse and baseline mood state could be predictors of psychiatric hospitalization. These results may be useful for clinicians seeking to prevent psychiatric hospitalization for bipolar disorder.

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Section: Discussioncontrasting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Predictors of psychiatric hospitalization among outpatients with bipolar disorder in the real-world clinical setting

Tokumitsu

Yasui‐Furukori

Adachi³

et al. 2023

Front. Psychiatry

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“…The acute manic and depressive episodes considerably increase the mental health services resource utilisation and corresponding healthcare costs with hospitalizations accounting for at least a quarter of the total direct costs of treating patients with BD [Cloutier et al, 2015]. Indeed, it has been reported that up to 75% of BD patients will suffer at least one relapse requiring hospitalisation in their lifetime [Bozzay et al, 2019].…”

Section: Introductionmentioning

confidence: 99%

A multicenter, 4-year mirror-image study comparing the effectiveness of long- acting injectable antipsychotics in the treatment of Bipolar Disorder: Results from the LAICO study

García-Carmona,

Barnett,

Campos-Navarro

et al. 2024

Preprint

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Background: This was a 4-year mirror-image study of adult patients diagnosed with bipolar disorder (BD) assessing the effects on treatment continuation and hospitalisation between aripiprazole 1-month (A1M) risperidone-LAI (R-LAI) and the monthly and 3-monthly formulations of paliperidone palmitate (PP1M, PP3M). We aimed to evaluate and compare the use of A1M, R-LAI and the monthly and 3-monthly formulations of paliperidone palmitate (PP1M, PP3M), by using the change of number and length of hospitalisations 2 years before compared to 2 years after initiation of LAIs for continuers and discontinuers. Secondary outcomes were: 1)discontinuation rates at 2 years and reasons per LAI, 2) time to discontinuation per LAI and 3)time to first hospitalisation per LAI. Results: A total of 122 BD were included, 74 continued LAI treatment at two years. Reasons for discontinuation were poor compliance (50%), ineffectiveness (43.2%) and tolerability issues (13.6%). Both time to individual LAI discontinuation and time to first hospital admission were significantly lower in the R-LAI group. There was a significant overall reduction in the number and length of hospitalisations two years before and after LAI initiation, although multivariate logistic regression analysis showed that A1M, PP1M and R-LAI were associated with an increased risk (OR=1.89, 95%CI=1.54–3.68, p=0.015; OR=1.63, 95%CI=1.29–2.77, p=0.022; OR=3.08, 95%CI=1.48-6.05, p=0.008, respectively) of bed usage compared to PP3M. Last, study completers showed a considerable drop of 79% in number of hospital admissions and 83% in bed days (p=0.001) as opposed to non-completers. Conclusions: Study findings suggest that long-acting antipsychotics such as A1M, PP1M and particularly PP3M are associated with high retention and lower hospitalisation rates after 2 years of treatment in patients with BD.

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Factors associated with hospitalization times and length of stay in patients with bipolar disorder

Shi,

Zhao,

Yang

et al. 2023

Front. Psychiatry

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AimAppraise the clinical features and influencing factors of the hospitalization times and length of stay in bipolar disorder (BD) patients.MethodsThis is a multicenter, observational, cohort study of patients diagnosed of type I or type II bipolar disorder. Five hundred twenty outpatients in seven hospitals from six cities in China were recruited from February 2013 to June 2014 and followed up using a continuous sampling pattern. The research included a retrospective period of 12 months and the prospective period of 9 months. The demographic and clinical features of the patients were collected. The influencing factors that could affect the length of stay (number of days spent in the hospital in the prospective period) were analyzed by poisson's regression and the hospitalization times (times of hospitalization in the prospective and retrospective period) was analyzed by general linear model. The selected variables included gender, age, years of education, occupational status, residence status, family history of mental disease, comorbid substance abuse, comorbid anxiety disorder, times of suicide (total suicide times that occurred in the retrospective and prospective period), polarity of the first mood episode, and BD type(I/II).ResultsPoisson's regression analysis showed that suicide times [Incidence Rate Ratio (IRR) = 1.20, p < 0.001], use of antipsychotic (IRR = 0.62, p = 0.011), and use of antidepressant (IRR = 0.56, p < 0.001) were correlated to more hospitalization times. Linear regression analysis showed that BD type II (β = 0.28, p = 0.005) and unemployment (β = 0.16, p = 0.039) which might mean longer duration of depression and poor function were correlated to longer length of stay. However, patients who experienced more suicide times (β = −0.21, p = 0.007) tended to have a shorter length of stay.ConclusionOverall, better management of the depressive episode and functional rehabilitation may help to reduce the length of stay. BD patients with more hospitalization times were characterized by higher risk of suicide and complex polypharmacy. Patients at high risk of suicide tended to have inadequate therapy and poor compliance, which should be assessed and treated adequately during hospitalization.Clinical trial registrationwww.ClinicalTrials.gov, Identifier: NCT01770704.

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Predictors of 30-day rehospitalization in a sample of hospitalized patients with Bipolar I disorder

Cited by 3 publications

References 20 publications

Predictors of psychiatric hospitalization among outpatients with bipolar disorder in the real-world clinical setting

Predictors of psychiatric hospitalization among outpatients with bipolar disorder in the real-world clinical setting

A multicenter, 4-year mirror-image study comparing the effectiveness of long- acting injectable antipsychotics in the treatment of Bipolar Disorder: Results from the LAICO study

Factors associated with hospitalization times and length of stay in patients with bipolar disorder

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