Identifying Patients in the Acute Psychiatric Hospital Who May Benefit From a Palliative Care Approach

  1. M. Caroline Burton, MD1
  2. Mark Warren, MD2
  3. Stephen S. Cha, MS3
  4. Maria Stevens, BA4
  5. Megan Blommer, BA5
  6. Simon Kung, MD2
  7. Maria I. Lapid, MD2

  1. 1Department of Medicine, Mayo Clinic, Jacksonville, FL, USA

  2. 2Department of Psychiatry, Mayo Clinic, Rochester, MN, USA

  3. 3Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

  4. 4Minnesota State University, Mankato Undergraduate University, Mankato, MN, USA

  5. 5University of St. Thomas, St. Paul, MN, USA
  1. M. Caroline Burton, MD, Department of Medicine, Mayo Clinic, 4500 San Pablo Drive, Jacksonville, FL 32224, USA. Email: burton.mcaroline{at}mayo.edu

Abstract

Identifying patients who will benefit from a palliative care approach is the first critical step in integrating palliative with curative therapy. Criteria are established that identify hospitalized medical patients who are near end of life, yet there are no criteria with respect to hospitalized patients with psychiatric disorders. The records of 276 consecutive patients admitted to a dedicated inpatient psychiatric unit were reviewed to identify prognostic criteria predictive of mortality. Mortality predictors were 2 or more admissions in the past year (P = .0114) and older age (P = .0006). Twenty-two percent of patients met National Hospice and Palliative Care Organization noncancer criteria for dementia. Palliative care intervention should be considered when treating inpatients with psychiatric disorders, especially older patients who have a previous hospitalization or history of dementia.

Article Notes

  • Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

  • Funding The authors received no financial support for the research, authorship, and/or publication of this article.