Analysis Of Risk Factors Of Sudden Death Of Psychiatric Inpatients In A Psychiatric Hospital In Recent 12 Years

Objective:Based on the analysis of the data of the patients with sud den death in a psychiatric hospital and the control patients without sudden death in more than 10 years,the correlation factors of sudden death in ps ychiatric patients were investigated.Methods:Inpatients with mental diseases who suffered sudden deat h from January 2010 to December 2021 in the research unit were selected as the research objects,and non-sudden death patients were selected as th e control(case ratio was 1:2).General demographic information,sudden death related information and disease-related information(including med ical history,diagnosis,treatment and examination)of the subjects were co llected using the self-compiled Data Collection Table of Inpatients with S udden Death Mental Illness.Univariate analysis was used to compare the inter-group differences of the aforementioned information between the tw o groups of patients,and independent sample chi-square test was perform ed on the categorical variables.Independent sample t test for continuous v ariables;With sudden death as the dependent variable and statistically sig nificant variables as independent variables,binary Logistics regression an alysis is conducted to explore the risk factors of sudden death.Results:A total of 40 patients with sudden death from psychosis and 80 patients in the control group were collected in this study.1.Univariate descriptive analysis of sudden death group:There were 22 males(55%)and 18 females(45%)in sudden death group;The mean age was 49±15.13 years old(13-76 years old),including 1 case of 0-18 y ears old(2.5%),8 cases of 18-35 years old(22.5%),21 cases of 35-60 ye ars old(52.5%),and 10 cases of 60 years old or older(25%).The time dist ribution of sudden death was as follows:24 cases(60%)from 0 o’clock t o 8 o’clock,1 case(2.5%)from 8 o’clock to 13 o’clock,4 cases(10%)fr om 13 o’clock to 18 o’clock,11 cases(27.5%)from 18 o’clock to 24 o’c lock.Sudden death occurred in 12 cases(30%)in spring,9 cases(22.5%)in summer,8 cases(20%)in autumn,and 11 cases(27.5%)in winter.The number of days between sudden death and hospital admission:13 cases within 3 days(32.5%),9 cases within 3 days to 1 week(22.5%),5 cases within 1 week to 2 weeks(12.5%),13 cases within 2 weeks or more(32.5%).2.Sudden death group and control group in single factor comparison:(1)the behavioral characteristics comparison:prior to admission patients with sudden death group alcohol prior to admission with the control grou p,differences are statistically significant(22.5%:7.5%,χ2=5.49,P=0.019).(2)Psychiatric illness:sudden death/antipsychotic medication taken 24 hours before discharge(90.0%:82.5%,χ2=4.27,P=0.039),length o f hospital stay(χ2=36.56,P<0.001),for the first time see age 62.9±30.1(t=1.99,P=0.049),hospitalization of somatic disease(57.5%:36.3%,χ2=4.90,P=0.027),always in the hospital the body disease(90.0%:82.5%,χ2=4.27,P=0.004),hospitalization,fever(60.0%:32.5%,χ2=8.30,P=0.009),24 hours before the hospital constraint(15.0%:0.0%,χ2=13.83,P<0.001),hospitalization(37.5%:13.7%,χ2=8.86,P=0.003)is statistically significant differences in two groups of data.(3)th e abnormal test before leaving hospital,hospital routine blood abnormaliti es(75.0%:50.0%,χ2=6.32,P=0.012),and abnormal myocardial enzy mes during the hospitalization(70.6%:44.3%,χ2=6.09,P=0.014)to compare two groups of data difference was statistically significant.(4)ano maly check:before leaving hospital hospitalization craniocerebral CT abn ormalities(71.4%:33.3%,χ2=8.38,P=0.004),abnormal electrocardio gram during the hospitalization(95.0%:69.6%,χ2=8.59,P=0.003)to compare two groups of data difference was statistically significant.3.logistic regression analysis of sudden death group and control gro up indicated:Sudden death was associated with a history of alcohol consu mption,abnormal blood routine during hospitalization,abnormal electroc ardiogram during hospitalization,abnormal brain CT during hospitalizati on,abnormal myocardial enzymes during hospitalization,confinement du ring hospitalization,fever during hospitalization,prior physical illness,ph ysical illness during hospitalization,and sudden death/antipsychotic drug use 24 hours before discharge.History of alcohol consumption(OR=4.678,P=0.005),abnormal blood routine during hospitalization(OR=3,P=0.014),abnormal electrocardiogram during hospitalization(OR=8.291,P=0.006),abnormal cranial CT during hospitalization(OR=5,P=0.005),abnor mal myocardial enzyme during hospitalization(OR=3.022,P=0.015),conf inement during hospitalization(OR=3.764,P=0.004),fever during hospit alization(OR=3.37,P=0.011),previous physical disease(OR=3.115,P=0.005),physical disease during hospitalization(OR=2.379,P=0.028),sudde n death/antipsychotic drug use 24 hours before discharge(OR=3.203,P=0.047)were risk factors for sudden death.Conclusion:1.Male patients with sudden death in psychiatric inpatients accounte d for 55%,most of which occurred in middle age(35-60 years old),accou nting for 52.5%;patients with sudden death in winter and spring accounte d for 57.5%;patients with sudden death from 0 o’clock to 8 o’clock acco unted for 60%;patients with sudden death within two weeks of admission accounted for 67.5%.2.A history of alcohol consumption in psychiatric inpatients prior to admission is a risk factor for sudden death.3.Patients with abnormal blood routine,electrocardiogram,cranioce rebral CT and myocardial enzymes during hospitalization,as well as cons traints and fever during hospitalization,and patients with physical disease s before and during hospitalization are more likely to suffer sudden death.4.Sudden death/Discharge patients who received antipsychotics 24 hours before discharge have an increased risk of sudden death.