Hospital admissions for respiratory system diseases in adults with intellectual disabilities in Southeast London: a register-based cohort study

TY - JOUR

T1 - Hospital admissions for respiratory system diseases in adults with intellectual disabilities in Southeast London

T2 - a register-based cohort study

AU - Chang, Chin-Kuo

AU - Chen, Chih-Yin

AU - Broadbent, Matthew

AU - Stewart, Robert James

AU - O'Hara, Jean

PY - 2017/3/29

Y1 - 2017/3/29

N2 - 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.

AB - 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.

UR - https://www.scopus.com/pages/publications/85034596742

U2 - 10.1136/bmjopen-2016-014846

DO - 10.1136/bmjopen-2016-014846

M3 - Article

SN - 2044-6055

JO - BMJ Open

JF - BMJ Open

M1 - e014846

ER -