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Yıl:2022; Cilt: 25; Sayı: 4>> Özet
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Klinik Psikiyatri Dergisi; 2022;25(4):386-394
Psikotik belirtili psikiyatrik hastalıklarda hastanede kalışı ve bir yıl içindeki tekrarlayan kabulü ön gören değişkenler: Retrospektif bir çalışma
Ç Geniş, MH Aksu, B Coşar
Kocaeli İl Sağlık Md., Kocaeli
Amaç: Bu çalışmada, psikotik belirtili psikiyatrik bozukluklarda hastanede kalış süresini ve taburculuk sonrası bir yıl içindeki tekrarlayan kabulü öngören değişkenleri araştırmayı amaçladık. Yöntem: Çalışma, 2005-2016 yılları arasında Gazi Üniversitesi psikiyatri bölümünde yatarak tedavi gören hastaların verileri ile gerçekleştirildi. Psikotik semptomları olan psikiyatrik bozukluklar çalışmaya dahil edildi. Tanı için temel olarak ICD-10 kullanıldı. 1301 tek başvuru ve 369 tekrarlayan kabul olmak üzere toplam 1670 hasta verisi analize dahil edildi. Analizde sadece ilk başvuru kayıt verileri kullanıldı. Bulgular: Hastanede kalış süresini uzatan anlamlı değişkenler önem sırasına göre şizofreni tanısının olması (β=0.186), kadın cinsiyet (β=-0,129), depresyon tanısının olması (β=0,106), tekrarlayan kabulün olması (β=0,099), şizoafektif bozukluk tanısının olması (β=0,055) ve ileri yaş (β=0,053) idi. Tekrarlayan kabulü olan hastaların %33,9'u ilk yıl içinde yeniden kabul edildi. Psikotik belirtileri olan hastalarda ilk kabul sonrası ilk bir yıl içinde tekrarlayan kabulü yordayan değişkenler ise önem sırasına göre; şizofreni tanısının olmaması (OR=0,368, p=0,002), hastanede kalış süresinin kısa olması (OR=0,981, p=0,007) ve şizoafektif bozukluk tanısının olmamasıdır (OR=0,333, p=0,011). Sonuç: Şizofreni ve şizoaffektif bozukluk tanısı hastanede kalış süresini uzatan yordayıcılar olmakla birlikte, tekrarlayan yatışı azaltan önemli yordayıcılardır. Bu hastalıkların varlığı ilk bakışta çelişkili görünse de hastanede kalış süresinin uzaması bu hastalıkların ilk yıl yeniden hastaneye yatmasını engelleyebilir. Bu bir öngörü olmakla birlikte, hastanede kalış süresinin uzaması nedeniyle tekrarlayan başvuruların azalması bu öngörüyü desteklemektedir. Başta şizofreni ve şizoaffektif bozukluk olmak üzere psikotik belirtilerin eşlik ettiği psikiyatrik bozukluklarda kalış süresi ile tekrarlayan hastanede kalış arasındaki ilişki ilerideki çalışmalarda dikkate alınmalıdır.
The variables predicting the length of hospital stay and within one year recurrent admission in psychiatric
Objective: In this study, we aimed to investigate the variables that predict the length of hospital stay and recurrent admission within one year after discharge in psychiatric disorders with psychotic symptoms. Method: The study was conducted with the data of patients who were treated in the inpatient department of the psychiatry department of Gazi University between 2005-2016. Psychiatric disorders with psychotic symptoms were included in the study. ICD-10 was used as the basis for diagnosis. A total of 1670 data of patients were included in the analysis, including 1301 single admission and 369 recurrent admissions. Only the initial admission record data of the patients were used in the analysis. Results: Significant variables that prolong the duration of hospital stay are schizophrenia diagnosis (ß=0.186), female gender (ß=-0.129), depression diagnosis (ß=0.106), recurrent admission (ß=0.099), diagnosis of schizoaffective disorder (ß=0.055), and advanced age (ß=0.053). 33.9% of patients with recurrent admission were readmitted within the first year. Variables predicting recurrent admission in the first year after first admission in patients with psychotic symptoms are, in order of importance; The absence of a diagnosis of schizophrenia (OR=0,368, p=0,002), a short hospital stay (OR=0,981, p=0,007) and no diagnosis of schizoaffective disorder (OR=0,333, p=0,011). Conclusion: Although the diagnosis of schizophrenia and schizoaffective disorder are predictors that prolong hospital stay, they are significant predictors that reduce recurrent admission. Although the presence of these disorders may seem contradictory at first glance, the prolonged hospital stay may prevent the re-hospitalization of these disorders in the first year. Although this is a prediction, the decrease in recurrent admission as the length of hospitalization supports this prediction. The relationship between the length of stay and recurrent hospitalization in psychiatric disorders accompanied by psychotic symptoms, especially schizophrenia and schizoaffective disorder, should be considered in further studies.

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