Underweight and hypoalbuminemia as risk indicators for mortality among psychiatric patients with medical comorbidities

Aim Medical comorbidities are a major cause of death among patients with mental illness. The purpose of this study was to clarify the risk factors for mortality among psychiatric patients with medical comorbidities. Methods We retrospectively reviewed the clinical files of patients transferred to Tokyo Metropolitan Matsuzawa Hospital from a psychiatric hospital to treat medical comorbidities during the three-year period from January 2014 to December 2016. We analyzed the clinical differences between the expired and alive patients. Results Of the 287 patients included, 29 (10.1%) had expired at the time of hospital discharge, while 258 (89.9%) were living. A multivariable analysis to determine the prognostic factors related to mortality from medical comorbidities showed that BMI <18.5 had the highest odds ratio among the predictive factors (5.1; 95% confidence interval [CI] 1.5-17.1; p<0.05), followed by a serum albumin level <3.0 mg/dl (3.0; 95% CI 1.1-8.1; p<0.05). Conclusions We found that underweight and hypoalbuminemia were risk factors for mortality among psychiatric patients with medical comorbidities. Physicians at psychiatric hospitals should consider transferring patients with medical comorbidities to a general medical hospital in the presence of underweight and/or hypoalbuminemia.