Psychiatric consultations and length of hospital stay

OBJECTIVE: To examine factors affecting the length of hospital stay (LOS) of patients referred to psychiatric consultation liaison (C-L) services.

METHODS: The study sample prospectively included all the referrals in 2004 to the C-L psychiatry unit at King Khaled University Hospital in Riyadh, Kingdom of Saudi Arabia. The following factors were documented for each consultation: patient demographic characteristics, dates of admission, consultation, and discharge, and total days of stay, medical specialty service requesting the consultation, reason for referral given by the referring physician, and the Diagnostic and Statistical Manual of Mental Disorders DSM-IV diagnosis, based on the consultation interview.

RESULTS: The total number of referrals was 264. The LOS showed positive correlation with referral time (p=0.0001) accounting for 22% of the variance in LOS. Surgical ward admission and diagnosis of delirium predicted longer LOS, while obstetric/gynecology ward admission, diagnosis of anxiety, and diagnosis of bipolar affective disorder predicted shorter LOS.

CONCLUSION: The direct correlation between the timing of referral and LOS reinforces that it is important for medical professionals to identify and detect patients who require early psychiatric intervention. Ways of detecting high-risk patients are discussed.