Pulmonary disease among inpatient decedents: Impact of schizophrenia
Abstract
Objectives Determine the risk associated with schizophrenia for common pulmonary illness (pneumonia and chronic obstructive pulmonary disorder (COPD)) during the last year of life.Methods Inpatient decedents in Veterans (VA) hospitals in 2002 (N=27,798) were identified. Logistic regression modeled diagnosis of pulmonary illness in either the final year or final admission as a function of schizophrenia, smoking history and other covariates.Results Among decedents, 943 (3%) had schizophrenia, 3% were women, most were white (76%) or African-American (18%), and average age at death was 72.4 years (SD 11.5). Three-fifths received VA outpatient care in the year prior to death. Among those with schizophrenia, only two-fifths had outpatient care. Pneumonia was more common among schizophrenia patients (38% vs 31%) as was COPD (46% vs 38%). In models controlling for history of smoking and other covariates, schizophrenia was a risk factor for pulmonary disease in the last year of life (OR=1.9, 95% CI 1.6-2.2) but less so for final-stay pulmonary disease (OR=1.5, 95% CI 1.3-1.7).Conclusions VA inpatient decedents with schizophrenia were at increased risk for pneumonia and COPD, independent of smoking indicators. Clinicians treating schizophrenia patients need to be especially alert to potential comorbid medical conditions and ensure vulnerable patients receive appropriate care.
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The prevalence of chronic obstructive pulmonary disease (chronic bronchitis and emphysema) is significantly higher among those with SMI than comparison subjects.
“The prevalence of chronic obstructive pulmonary disease, i.e. chronic bronchitis and emphysema, is significantly higher among those with SMI than comparison subjects (429-433).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [433]
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DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488 · see citing works
- Authors
- Copeland, L. A., Mortensen, E. M., Zeber, J. E., Pugh, M. J., Restrepo, M. I., & Dalack, G. W.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- University of Michigan (US)
- Corresponding author
- Copeland, Laurel A.
- ORCID
- Venue
- Progress in Neuro-Psychopharmacology and Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2007-04
- Volume
- 31
- Issue
- 3
- Pages
- 720-726
- ISSN
- 0278-5846 (ISSN-L)
- OpenAlex
- W2015150204
- Cited by
- 46
- References
- 49
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 3 · 2019: 2 · 2018: 6 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 5 · 2013: 6 · 2012: 4
- FWCI
- 1.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Progress in Neuro-Psychopharmacology and Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- schizophrenia, lung disease, pneumonia, chronic obstructive pulmonary disease, veterans, smoking history, comorbidities, end-of-life care, veterans' health care
- MeSH terms
- Adult, Aged, Aged, 80 and over, Demography, Female, Humans, Lung Diseases, Male, Middle Aged, Retrospective Studies, Risk Factors, Schizophrenia, Veterans, Logistic Models, Hospital Mortality
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