Factores asociados al reingreso hospitalario en pacientes con trastorno bipolar en Valle del Cauca, Colombia / Factors related with hospital readmission in patients with bipolar disorder in Valle del Cauca, Colombia

RESUMEN

RESUMEN Objetivo Identificar factores asociados con el reingreso hospitalario en pacientes con trastorno bipolar (TB) en un hospital psiquiátrico y desarrollar un modelo explicativo del riesgo de reingreso. Método Estudio observacional longitudinal retrospectivo a partir de base de datos secundaria aportada por el Hospital Psiquiátrico Departamental Universitario del Valle. Estadística análisis de supervivencia utilizando un modelo de regresión Cox. Se definió como variable dependiente el riesgo de reingreso y como variables independientes algunas sociodemográficas y clínicas. Resultados Se obtuvo una asociación estadísticamente significativa entre el riesgo de reingreso y las variables falta de red de apoyo al no tener acudiente HR=1,33 [IC 95% 1,02-1,72; (p=0,034)] y falta de adherencia al tratamiento HR=2,33 [IC 95% 1,87-2,90; (p=0,000)]. Conclusión Para disminuir el reingreso hospitalario por TB, se deben priorizar las intervenciones en los casos de pacientes que no tengan acudiente y haya inadecuada adherencia al tratamiento; esta última, a partir de la percepción por parte del médico especialista. Enfocarse sobre estos dos factores puede incidir sobre los reingresos.

ABSTRACT

ABSTRACT Objective To identify the factors associated with hospital readmission in patients with bipolar disorder between 2011 and 2017 in a psychiatric hospital in order to develop an explanatory model of the risk of rehospitalization. Method Retrospective longitudinal observational study based on a secondary database provided by the Hospital Psiquiátrico Departamental Universitario del Valle. Statistics Survival analysis using a Cox regression model. The risk of readmission was defined as a dependent variable and some sociodemographic and clinical variables were defined as independent variables. Results From the multivariate model of Cox Regression, a statistically significant association was obtained between the risk of readmission and the variables lack of support network due to lack of retentive HR=1.33 [95% CI 1.02-1.72; (p=0.034)] and not having adherence to the treatment HR=2.33 [95% CI 1.87-2.90; (p=0.000)]. Conclusion In order to reduce hospital readmission due to bipolar disorder, interven-tions should be prioritized in cases where patients do not have a guardian and there is inadequate adherence to the treatment; the latter perceived by the specialist doctor. Focusing on these two factors can influence readmissions.