“Factors predicting admission of psychiatric emergency contacts after presenting to the emergency department – results of a regression analysis.”

Abstract

BackgroundPsychiatric emergency patients have great relevance in the interdisciplinary emergency department. Emergency physicians in this setting often have to make decisions under time pressure based on incomplete information regarding the patient's further treatment. The aim of this study was to identify possible predictors associated with an increased likelihood of inpatient psychiatric admission, thereby facilitating future decision-making processes for clinicians regarding further treatment.MethodsA retrospective cross-sectional study of all psychiatric emergency contacts in an interdisciplinary emergency department (ED) of a general hospital in a large German city was conducted for 2015. A binary regression analysis was performed to identify possible predictors.ResultsFactors associated with an increased probability of inpatient psychiatric admission were previously known patients, patients under a legal care order (guardianship), and previous outpatient medical contact. No association for gender or age was found. Data demonstrated a negative relationship between a neurotic, stress-related and somatoform disorder diagnosis and admission.ConclusionsThe conducted study showed some significant characteristics associated with an increase likelihood of emergency admission. Particularly noteworthy is the negative relationship between a neurotic, stress-related and somatoform disorder diagnosis and admission. To improve the treatment of patients in emergency units, these factors should be taken into account. Further studies should be undertaken in order to develop specific emergency admission algorithms comparable to internal medicine.