Increased Risks of Death and Hospitalization in Influenza/Pneumonia and Sepsis for Individuals Affected by Psychotic Disorders, Bipolar Disorders, and Single Manic Episodes: A Retrospective Cross-Sectional Study

Nilsson, Niklas; Bendix, Marie; Öhlund, Louise; Widerström, Micael; Werneke, Ursula; Maripuu, Martin

doi:10.3390/jcm10194411

Cited by 11 publications

(4 citation statements)

References 61 publications

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“…Mental illness was more prevalent among LIJ ED patients with sepsis (26.9%) than among the broader U.S. population (21.0% 11 ) and than among our ED’s non-septic population (5.8%; p <0.0001). Such results are consistent with the above-mentioned Swedish study’s 7 observation that patients with mental health disorders were more likely to have sepsis.…”

Section: Discussionsupporting

confidence: 92%

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Sepsis in patients with vs. without mental illness: a comparison of demographic, insurance, comorbidity, and infection source characteristics

Chen,

Sierra,

Jacob

et al. 2024

Preprint

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Background Adherence to the Surviving Sepsis Campaign's 3- and 6-hour bundles (blood cultures/serum lactate/antibiotics/IV fluids/vasopressors) improves mortality. Septic patients with mental health illness may not receive optimal care, being unable to explain symptoms, understand/accept their condition/care, or remain calm. We compare characteristics of ED septic patients with vs without mental health illnesses in their demographics, insurance, housing status, comorbidities, and infected organs, part of a larger, retrospective study seeking to compare such patients' sepsis care quality (bundle adherence, length-of-stay (LOS)). Methods Patients with sepsis (and their infection source) between 2017-2019 were identified from a health system sepsis reporting database. Their characteristics of history of mental health illness (cognitive, mood, personality, schizophrenia, psychosis, substance use), demographics, insurance, housing status, and comorbidities were obtained via electronic health record query. Such characteristics were compared among patients with vs without mental illness. Results A greater percent of septic patients than the overall U.S. population had a mental illness (26.9% vs 21%). In univariate analysis, patients with mental illnesses were older (77.9 vs 67.6 years), more-likely to be from a psychiatric facility/group home (32.5% vs 2.1%; p<0.0001), have Medicare (58% vs 47.1%; p=0.0201), have more than 1 comorbidity (72.6% vs 0.6%; p<0.0001), and have a respiratory source of sepsis. People without mental illnesses were more-often from either a private home/nursing home (75.2% vs 56.7%; p<0.0001) or clinic (8.9% vs 3.2%; p=0.0191), have private insurance (15.2% vs 7.6%; p=0.0167), and have immune- modifying medications or cancer (20.7% vs 7%; p<0.0001). Discussion Compared with national rates of mental health illness, a higher percent of septic patients (26.9% vs. 21%) had mental illness (mostly neurocognitive). Septic patients with mental illnesses tended to be older, from a psychiatric facility/group home, have Medicare, have ≥1 comorbidity, and have a respiratory source of sepsis. Patients without mental illnesses more-often had immune-modifying medications and malignancy. Patients with mental health illnesses were more-likely to have a respiratory source of their sepsis, perhaps due to higher risk for aspiration or respiratory contagion in group homes/psychiatric facilities. Clinicians may want to specifically test or empirically treat for respiratory sources in this population. Future analyses (multivariate) will determine whether differences in quality of care, mortality, or length of stay exist, and if specific characteristics above were associated with these different outcomes. Limitations: The study was based on data from a single hospital system, which might limit generalizability. Additionally, the study relied on data collected for sepsis management, which might not capture all patients with sepsis or those who did not receive the sepsis bundle. Furthermore, all data collected pertaining to this study was only in the timeframe between 2018-2019. The proportion of septic patients with vs. without mental health disorders during and following the COVID pandemic may differ from the earlier time frame represented in this study.

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Section: Discussionsupporting

confidence: 92%

“…They also had an increased risk of hospitalization associated with influenza/pneumonia (OR = 2.12) and sepsis (OR = 1.89), suggesting greater severity. 7 This current study aims to add to the literature regarding mental illness and sepsis outcomes.…”

Section: Introductionmentioning

confidence: 99%

Sepsis in patients with vs. without mental illness: a comparison of demographic, insurance, comorbidity, and infection source characteristics

Chen,

Sierra,

Jacob

et al. 2024

Preprint

View full text Add to dashboard Cite

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“…When lithium carbonate is utilized as a therapeutic approach, monitoring the patient's blood lithium concentration becomes crucial, and therapeutic drug monitoring has become an integral part of standard lithium carbonate therapy. When the blood lithium concentration is ≥1.50 mmol/L, the likelihood of experiencing severe ARs significantly increases, leading to damage to the nervous system, endocrine system, cardiovascular system, and symptoms such as dizziness, impaired consciousness, nausea, vomiting, and dry mouth (Nilsson et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

TCF3/ACSS2 Axis Promotes Proliferation and Colony-Forming Capacity of Esophageal Squamous Cell Carcinoma Cells

2023

PJZ

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“…But the beginnings of the pandemic did not only leave health care workers highly vulnerable. Patients, particularly when suffering from severe conditions such as cancer, may have been at an increased risk of post-traumatic stress, when resources were withdrawn and treatments were delayed ( (14). As judged by increased hospitalization rates (15), the higher mortality risk may be more likely linked to an increased risk of an adverse clinical course of a COVID-19 infection than to an increased risk of infection per se.…”

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confidence: 99%

Editorial: Outbreak Investigation: Mental Health in the Times of Coronavirus (COVID-19)

et al. 2022

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Two years ago, on 20 January 2020, the World Health Organisation (WHO) declared the COVID-19 outbreak a public health emergency of international concern. At that time, it was unclear what lay ahead in terms of its impact on mental health of populations, although some lessons from previous epidemics and pandemics were already available. With all focus on physical survival, mental health was put on the back burner. However, concerns started building up rapidly. How would people without a history of mental health problems cope with the psychological fallout from the COVID-19 pandemic? And how would those with already existing mental health problems cope? To monitor this unfolding mental health crisis, we embarked on our Research Topic on 3 April 2020. At that time, there were over one million COVID-19 cases recorded worldwide. The death toll had surpassed 50,000. Two years later, at the time of writing this editorial on 13 January 2022, there were over 300 million cases recorded world-wide. The death toll had surpassed 5.5 million people (1).The recent Omicron variant has made it clear that COVID-19 is not going away. But this may not necessarily mean doom. The Omicron variant, albeit much more transmissible, seems much milder. Cases have surged globally, hospitalization and death rates have not. Preprint data from South Africa, where the Omicron variant was first reported, indicates 80% reduced odds for hospitalization and 70% reduced odds for severe disease (2). Still, due to the sheer numbers of infections, the death toll may rise. Concerns about hospital and intensive care capacities have led some countries to re-introduce lock-down measures. This has caused havoc in vulnerable industries, such as tourism and gastronomy. They had their hopes set on a strong rebound during the 2021 festive season, only to shut down again. However, even that situation is changing rapidly. The milder course of Omicron and a shorter incubation time [3 days (3)] suggest that selfisolation measures could be relaxed. On 27 December 2021, the US Centers for Disease Control and Prevention (CDC) shortened quarantine time from 10 to 5 days for people testing positive but asymptomatic (4). South Africa went even further, scrapping the need for isolation altogether in asymptomatic individuals. One day later though, after an intense flood of media, stakeholders and public enquiries, the new isolation and quarantine rules were recalled (5). Meanwhile, Germany discusses school closures (6).

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Increased Risks of Death and Hospitalization in Influenza/Pneumonia and Sepsis for Individuals Affected by Psychotic Disorders, Bipolar Disorders, and Single Manic Episodes: A Retrospective Cross-Sectional Study

Cited by 11 publications

References 61 publications

Sepsis in patients with vs. without mental illness: a comparison of demographic, insurance, comorbidity, and infection source characteristics

Sepsis in patients with vs. without mental illness: a comparison of demographic, insurance, comorbidity, and infection source characteristics

TCF3/ACSS2 Axis Promotes Proliferation and Colony-Forming Capacity of Esophageal Squamous Cell Carcinoma Cells

Editorial: Outbreak Investigation: Mental Health in the Times of Coronavirus (COVID-19)

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