Excess heart-disease-related mortality in a national study of patients with mental disorders: identifying modifiable risk factors
Excess heart-disease-related mortality in a national study of patients with mental disorders: identifying modifiable risk factors
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DOI：
10.1016/j.genhosppsych.2009.07.008
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发表时间：
2009-11-01
影响因子：
7
通讯作者：
Blow, Frederic C.
中科院分区：
文献类型：
--
作者：
Kilbourne, Amy M.;Morden, Nancy E.;Blow, Frederic C.
目的：据估计，精神障碍患者的死亡年龄比一般人群年轻25岁，而心脏病（HD）是导致他们死亡的主要原因。我们评估了退伍军人事务（VA）卫生系统中患有精神障碍的患者是否比没有这些疾病的患者更容易死于HD，以及可改变的因素是否可以解释不同的死亡率风险。方法：研究对象包括完成1999年退伍军人大健康调查（LHSV）的退伍军人事务部患者，这些患者要么被诊断为精神分裂症、双相情感障碍、其他精神障碍、重度抑郁症或其他抑郁症，要么未被诊断为这些疾病。LHSV关于患者社会人口学、临床和行为因素（如身体活动、吸烟）的数据与疾病控制和预防中心国家死亡指数的死亡率数据相关联。采用分层多变量Cox比例风险模型，结合患者社会人口学、临床和行为因素，评估8年hd相关死亡风险。结果：147193名受访者中，11809人（8%）死于HD。在控制了社会人口学和临床因素后，我们发现精神分裂症患者[危险比(HR)=1.25；95%置信区间（95% CI）： 1.15-1.36；P
Objective: People with mental disorders are estimated to die 25 years younger than the general population, and heart disease (HD) is a major contributor to their mortality. We assessed whether Veterans Affairs (VA) health system patients with mental disorders were more likely to die from HD than patients without these disorders, and whether modifiable factors may explain differential mortality risks.Methods: Subjects included VA patients who completed the 1999 Large Health Survey of Veteran Enrollees (LHSV) and were either diagnosed with schizophrenia, bipolar disorder, other psychotic disorders, major depressive disorder or other depression diagnosis or diagnosed with none of these disorders. LHSV data on patient sociodemographic, clinical and behavioral factors (e.g., physical activity, smoking) were linked to mortality data from the National Death Index of the Centers for Disease Control and Prevention. Hierarchical multivariable Cox proportional hazards models were used to assess 8-year HD-related mortality risk by diagnosis, adding patient sociodemographic, clinical and behavioral factors.Results: Of 147,193 respondents, 11,809 (8%) died from HD. After controlling for sociodemographic and clinical factors, we found that those with schizophrenia [hazard ratio (HR)=1.25; 95% confidence interval (95% CI): 1.15-1.36; P