To identify factors associated with infection-related hospitalisations and explore how these factors cluster together within the patient population.
Approach:
Study Design: Retrospective cohort study using linked electronic health records from a large secondary mental health service in South London.
Participants: Individuals with a severe mental illness (SMI) diagnosis between 1 January 2007 and 31 December 2019.
Analysis: Cox regression models examined associations between various factors and time to first infection-related hospitalisation, followed by hierarchical cluster analysis.
Key Findings:
Strongest factors associated with infection-related hospitalisations included number of general hospital admissions for ambulatory care sensitive conditions (HR=2.31, 95% CI 2.08 to 2.56), clozapine prescribing (HR=1.67, 95% CI 1.45 to 1.92), and severe problems with physical illness/disability (HR=1.36, 95% CI 1.31 to 1.42).
Two distinct patterns emerged: one with older age, dementia, and poor physical health; the other with younger age, complex psychiatric needs, and substance use.
Interpretation:
The study identified several factors associated with infection-related hospitalisations and highlighted clustering patterns among people with SMI.
Limitations:
The study's retrospective design may limit causal inferences.
Follow-up ended in 2019, potentially missing data related to the COVID-19 pandemic.
Conclusion:
The findings indicate factors associated with infection-related hospitalisation in people with SMI.
