Abstract
Background: Intellectual disability (ID) carries a high impact on need for care, health status, and premature mortality. Respiratory system diseases contribute a major part of mortality among people with ID, but remain under-investigated as consequent morbidities.
Methods: Anonymised electronic mental health records from the South London and Maudsley Trust (SLaM) were linked to national acute medical care data. Using retrospective cohort and matched case-control study designs, adults with ID receiving SLaM care between 1 January 2008 and 31 March 2013 were identified and compared to local catchment residents for respiratory system disease admissions. Standardised admission ratios (SARs) were first calculated, followed by a comparison of duration of hospitalisation with respiratory system disease between people with ID and age- and gender-matched random counterparts modelled using linear regression. Finally, the risk of readmission for respiratory system disease was analysed using Cox models.
Results: For the 3,138 adults with ID identified in SLaM, the SAR for respiratory system disease admissions was 4.02 (95% CI: 3.79, 4.26). Compared to adults without ID, duration of hospitalisation was significantly longer by 2.34 days (95% CI: 0.03, 4.64) and respiratory system disease readmission was significantly elevated (hazard ratio=1.35; 95% CI: 1.17, 1.56) after confounding adjustment.
Conclusions: Respiratory system disease admissions in adults with ID are more frequent, of longer duration, and have a higher likelihood of recurring. Development and evaluation of potential interventions to the preventable causes of respiratory diseases should be prioritised.
Methods: Anonymised electronic mental health records from the South London and Maudsley Trust (SLaM) were linked to national acute medical care data. Using retrospective cohort and matched case-control study designs, adults with ID receiving SLaM care between 1 January 2008 and 31 March 2013 were identified and compared to local catchment residents for respiratory system disease admissions. Standardised admission ratios (SARs) were first calculated, followed by a comparison of duration of hospitalisation with respiratory system disease between people with ID and age- and gender-matched random counterparts modelled using linear regression. Finally, the risk of readmission for respiratory system disease was analysed using Cox models.
Results: For the 3,138 adults with ID identified in SLaM, the SAR for respiratory system disease admissions was 4.02 (95% CI: 3.79, 4.26). Compared to adults without ID, duration of hospitalisation was significantly longer by 2.34 days (95% CI: 0.03, 4.64) and respiratory system disease readmission was significantly elevated (hazard ratio=1.35; 95% CI: 1.17, 1.56) after confounding adjustment.
Conclusions: Respiratory system disease admissions in adults with ID are more frequent, of longer duration, and have a higher likelihood of recurring. Development and evaluation of potential interventions to the preventable causes of respiratory diseases should be prioritised.
Original language | English |
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Article number | e014846 |
Journal | BMJ Open |
Early online date | 29 Mar 2017 |
DOIs | |
Publication status | E-pub ahead of print - 29 Mar 2017 |