AB076. SOH21AS054. Impact of psychiatric comorbidities on emergency surgical patients’ outcomes

Abstract

Background: Psychiatric disorders are increasingly prevalent. Studies have demonstrated that the presence of comorbid psychiatric conditions (CPC) is associated with worsened inpatient outcomes. Emergency surgical admissions and the impact of CPC on their outcomes has not been studied in Ireland to date. Methods: The Hospital In-Patient Enquiry (HIPE) and eDischarge system were used to identify all surgical emergency admissions between 31st August 2019 and 1st September 2020 to Mayo University Hospital. Patient demographics, comorbidities, primary diagnoses, length of stay (LoS), discharge destination, and surgical interventions were recorded. Statistical calculations were performed using Statistical Package for the Social Sciences (SPSS). Results: A total of 995 admissions were recorded. The presence of CPC increased the overall mean LoS by 1.9 days (P=0.002). This trend was observed in both operative and conservative management. Significant increase in LoS was noted in patients with comorbid depression (2.4 days, P=0.003), dementia (2.9 days, P=0.019), and intellectual disability (11.6 days, P=0.007). Subgroup analysis revealed greater LoS in patients with CPC diagnosed with nonspecific abdominal pain (1.4 days, P=0.019), skin and soft tissue infections (2.5 days, P=0.040), bowel obstruction (4.3 days, P=0.047), and medical disorders (18.6 days, P=0.010). Patients with CPC were five times more likely to self-discharge (P=0.005) and 2.4 times more likely to be discharged to nursing homes or convalescence (P=0.002). No significant difference was observed in readmission rates. Conclusions: Psychiatric comorbidities significantly impact hospital LoS and influence discharge planning in surgical inpatients. Better optimisation of facilities and a more personalised approach to patients with CPC are required to improve inpatient outcomes and resource allocation.