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BMC Emergency Medicine
Published in: BMC Emergency Medicine 1/2016

Open Access 01-12-2016 | Research article

Psychological distress in medical patients 30 days following an emergency department admission: results from a prospective, observational study

Authors: Lukas Faessler, Alexander Kutz, Sebastian Haubitz, Beat Mueller, Pasqualina Perrig-Chiello, Philipp Schuetz

Published in: BMC Emergency Medicine | Issue 1/2016

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Abstract

Background

Psychological distress in medical patients admitted to the emergency department (ED) is not well studied. Our aim was to investigate the extent of psychological distress in a broad and unselected medical patient sample 30 days after ED admission and its association with socio-demographic and clinical variables.

Method

We used data from a prospective observational cohort study including 1575 consecutive adult medical patients presenting to the ED with acute somatic conditions. Outcome variables were patient’s psychological distress measured by the 4-item Patient Health Questionnaire (PHQ–4) and self-rated health assessed 30 days after ED admission using telephone interviews. Risk factors included socio-demographic variables (e.g. gender, marital status), clinical presentation (e.g. illness severity, main initial diagnosis) and course of illness (e.g. rehospitalisation, length of hospital stay).

Results

A total of 38 % of patients had evidence for psychological distress 30 days after ED admission. Multivariate analysis found female gender (adjusted odds ratio [aOR] 1.35, 95 % confidence interval [CI] 1.02 to 1.78), comorbid psychiatric disorder (aOR 1.63, 95 % CI 1.08 to 2.62), discharge to a post-acute care institution (aOR 1.47, 95 % CI 1.03 to 2.09), unplanned rehospitalisation (aOR 2.38, 95 % CI 1.47 to 3.86), and unplanned visit at general practitioner (aOR 4.75, 95 % CI 2.57 to 8.80) to be associated with distress at day 30 following ED admission.

Conclusions

One month after ED admission a significant number of patients still show a moderate amount of psychophysical distress. Strongest related variables were course of illness, in particular unplanned general practitioner visits. Future interventional studies should assess possibilities to reduce distress in patients at increased risk.

Trial registration

NCT01768494, January 9, 2013 (registration date), February 25, 2013 (enrolment of first participant).
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Metadata
Title
Psychological distress in medical patients 30 days following an emergency department admission: results from a prospective, observational study
Authors
Lukas Faessler
Alexander Kutz
Sebastian Haubitz
Beat Mueller
Pasqualina Perrig-Chiello
Philipp Schuetz
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2016
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-016-0097-y

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