European Psychiatry (Jan 2025)

Metabolic syndrome and its components are associated with lengths of stay in a psychiatric hospital: Results from a Swiss psychiatric cohort and first-episode psychosis patients

  • Nermine Laaboub,
  • Setareh Ranjbar,
  • Séverine Crettol,
  • Nicolas Ansermot,
  • Frederik Vandenberghe,
  • Carole Grandjean,
  • Marianna Piras,
  • Julien Elowe,
  • Martin Preisig,
  • Armin Von Gunten,
  • Philippe Conus,
  • Chin Bin Eap

DOI
https://doi.org/10.1192/j.eurpsy.2025.10036
Journal volume & issue
Vol. 68

Abstract

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Abstract Background Due to limited inpatient care resources and high healthcare expenditures, understanding factors that affect lengths of stay (LOS) is highly relevant. We aimed to investigate associations between metabolic disturbances and LOS in a psychiatric hospital and to identify other clinical and sociodemographic LOS predictors. Methods Patients admitted to one of the units of the general psychiatric or psychogeriatric departments between January 1, 2007 and December 31, 2020, were included. Metabolic disturbances (i.e., the metabolic syndrome and its five components) were defined using the International Diabetes Federation definition. Cox frailty regression models with time-varying coefficients were used to investigate the association between metabolic disturbances and LOS. Hazard ratios (HR) >1 and HR < 1 indicated the relative likelihood of shorter and extended LOS, respectively. Results A total of 7,771 patients for 16,959 hospital stays throughout 14 years of follow-up were included. Central obesity (HR = 0.82; 95% confidence interval [CI] = [0.76–0.89]), hyperglycemia (HR = 0.83; 95% CI = [0.78–0.89]), hypertriglyceridemia (HR = 0.87; 95% CI = [0.80–0.92]), and the metabolic syndrome (HR = 0.76; 95% CI = [0.70–0.82]) were associated with an increased risk of extended LOS in the psychiatric hospital, while underweight (HR = 1.30, 95% CI = [1.09–1.56]) and HDL hypocholesterolemia (HR = 1.10, 95% CI = [1.03–1.18]) were associated with a higher likelihood of shorter LOS. In first-episode psychosis patients, hypertriglyceridemia (HR = 0.82; 95% CI = [0.67–0.99]) and hypertension (HR = 0.76, 95% CI = [0.58–0.99]) were associated with extended LOS when considering all stays, while no association was found when considering the first stay per patient. Conclusion Future studies should determine whether better metabolic monitoring and treatment of metabolic disturbances can contribute to reducing LOS.

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