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BackgroundPersons with severe mental illness (SMI) have excess mortality, which may partly be explained by their high prevalence of diabetes.MethodWe compared the overall and cause-specific mortality in persons with SMI and diabetes with that of the general Danish population between 1997 and 2009 by linking data from Danish national registries.ResultsThe cohort counted 4 734 703 persons, and during follow-up 651 080 persons died of whom 1083 persons had SMI and diabetes. Compared with the background population, the overall mortality rate ratios (MRRs) for persons with SMI and diabetes were 4.14 [95% confidence interval (CI) 3.81–4.51] for men and 3.13 (95% CI 2.88–3.40) for women. The cause-specific MRRs for persons with SMI and diabetes were lowest for malignant neoplasms (women: MRR = 1.98, 95% CI 1.64–2.39; men: MRR = 2.08, 95% CI 1.69–2.56) and highest for unnatural causes of death (women: MRR = 12.31, 95% CI 6.80–22.28; men: MRR = 7.89, 95% CI 5.51–11.29). The cumulative risks of death within 7 years of diabetes diagnosis for persons with SMI and diabetes were 15.0% (95% CI 12.4–17.6%) for those younger than 50 years, 30.7% (95% CI 27.8–33.4%) for those aged 50–69 years, and 63.8% (95% CI 58.9–68.2%) for those aged 70 years or older. Among persons suffering from both diseases, 33.4% of natural deaths were attributed to diabetes and 14% of natural deaths were attributed to the interaction between diabetes and SMI.ConclusionsLong-term mortality is high for persons with SMI and diabetes. This calls for effective intervention from a coordinated and collaborating healthcare system. [ABSTRACT FROM AUTHOR]

Short-term rehospitalization and mortality are common events in older patients after a pneumonia admission, yet little knowledge exists on how to identify the patients at risk of these events. This knowledge is needed to ensure that health care attention is given to those with the highest needs. We therefore aimed to identify factors of importance for short-term rehospitalization and mortality in older patients after admission for pneumonia. Population-based cohort study. The Danish nationwide registries. In total, 246,245 individuals aged 65-99 years who experienced 298,564 admissions for pneumonia from 2000 to 2016. The explored factors in patients were demographic characteristics, health-seeking behavior, comorbidity, and medication use. A Cox proportional hazards model was used to calculate hazard ratios (HRs) for 30-day rehospitalization and 30-day mortality with 95% confidence intervals (CIs). Of the 298,564 admissions for pneumonia, 23.0% were rehospitalized and 8.1% died within 30 days of follow-up. Most of the investigated factors were significantly associated with these 2 outcomes. The HRs for rehospitalization ranged from 0.80 (95% CI 0.75-0.85) for old vs young age to 4.29 (95% CI 4.05-4.54) for many vs no prior admissions, whereas the HRs for mortality ranged from 0.87 (95% CI 0.83-0.91) for any vs no practical home care to 5.47 (95% CI 5.08-5.88) for old vs young age. Number of comorbidities, medications, and prior contacts to the health care system were associated with higher risk of both rehospitalization and mortality in a dose-response manner. This study identified several potential factors of importance for short-term rehospitalization and mortality in older patients discharged after pneumonia. This knowledge can help physicians identify the patients with the highest need of care after admission for pneumonia, thus enabling efficient discharge planning and high-quality provision of care in primary care settings. [ABSTRACT FROM AUTHOR]