Characteristics Associated with Length of Hospital Stay in Patients With Bipolar Disorder

Age, gender, and insurance type were associated with length of hospital stay during electroconvulsive therapy (ECT) management for bipolar disorder, according to study data presented at Psych Congress 2020 Virtual Experience, held online from September 11 to 13, 2020. The greatest odds for a hospital stay exceeding 16 days was noted in older adults, men, and patients with private insurance.

Investigators extracted data from the Nationwide Inpatient Sample for the years 2010 through 2014. The Nationwide Inpatient Sample comprises data from more than 7 million hospital stays each year. Inpatients aged 35 to 67 years who received ECT for bipolar disorder while hospitalized were eligible for study inclusion. The primary outcome was length of hospital stay (LOS), dichotomized as ≤16 days or >16 days. Logistic regression was performed to identify predictors of LOS >16 days. 

The study cohort comprised 2785 adult inpatients who received ECT for a primary diagnosis of bipolar disorder with manic episodes. Mean LOS was 21.6 days. Overall, 1355 inpatients (48.7%) experienced LOS >16 days. Older adults (aged >50 years) were significantly more likely to experience LOS >16 days compared with adults aged <50 years (odds ratio [OR], 2.43; 95% CI, 2.06-2.87). Men were twice as likely as women to be hospitalized for >16 days (OR, 1.89; 95% CI, 1.59-2.27). Although the cohort consisted of primarily White individuals, White patients were less likely to experience LOS >16 days compared with non-White patients (OR, 0.35; 95% CI, 0.28-0.41). Greater odds for LOS >16 days was reported for patients covered by private insurance or self-payment than for patients with public insurance (OR, 1.49; 95% CI, 1.27-1.77). Patients admitted to public hospitals were more likely than patients at private hospitals to experience LOS >16 days (OR, 1.92; 95% CI, 1.39-2.64). Hospital size and urbanicity of location were not significantly predictive of LOS. However, teaching hospital status was associated with increased odds of LOS >16 days (OR, 1.37; 95% CI, 1.12-1.68).

In this nationwide cohort study of US inpatients, extended length of hospital stay during ECT management was observed in older patients, men, and patients with private insurance. Patients admitted to public teaching hospitals experienced longer LOS than patients at private or nonteaching hospitals. The investigators advised initiating ECT early in a patient’s hospital stay (within 7 days) to reduce length of management.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry.

Please see the original reference for a full list of authors’ disclosures.

Reference

Bodicherla KP, Mathialagan K, Patel RS. Predictors for extending hospitalization stay in electroconvulsive therapy recipients with bipolar disorder, manic episodes. Presented at: Psych Congress 2020 Virtual Experience; September 11-15, 2020. Abstract 130.