Premature death after self-harm: a multicentre cohort study
Premature death after self-harm: a multicentre cohort study
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DOI：
10.1016/s0140-6736(12)61141-6
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发表时间：
2012-11-03
期刊：
影响因子：
168.9
通讯作者：
Kapur, Navneet
中科院分区：
文献类型：
--
作者：
Bergen, Helen;Hawton, Keith;Kapur, Navneet
自残的人过早死亡的风险增加。本研究的目的是调查原因特异性过早死亡的个人谁自伤，包括社会经济deprivation.Methods协会，我们进行了队列研究的所有年龄段的病人提出的急诊科在牛津，曼彻斯特和德比，英国，自中毒或自伤后，2000年1月1日至2007年12月31日。个人居住地的邮政编码与2007年英国多重拘留指数挂钩。死亡率信息由国家卫生署医学研究信息服务处提供。患者随访至2009年底。我们计算了年龄标准化死亡率（SMR）和年寿命损失（YLL），我们测试了与社会经济deprivation.Findings 30 950个人提出了自我伤害，并随访了中位数为6.0年（IQR 3.9-7.9）的协会。1832例（6.1%）患者在随访结束前死亡。患者死亡的可能性高于一般人群（SMR 3.6，95% CI 3.5-3.8），男性（4.1，3.8-4.3）的死亡率高于女性（3.2，2.9-3.4）。自然原因造成的死亡比预期的多2-7.5倍。对于死于任何原因的个体，男性患者的平均YLL为31.4年（95% CI 30.5-32.2），女性患者为30.7年（29.5-31.9）。男性患者自然原因死亡的平均YLL为25.9年（25.7-26.0），女性患者为25.5年（25.2-25.8），外部原因死亡的平均YLL分别为40.2年（40.0-40.3）和40.0年（39.7-40.5）。循环系统疾病（男性13.1%;女性13.0%）和消化系统疾病（男性11.7%;女性17.8%）是自然原因导致的YLL的主要原因。在男性患者中，全因死亡率随着社会经济剥夺的每一个四分位数而增加（χ 2趋势39.6; P
Background People who self-harm have an increased risk of premature death. The aim of this study was to investigate cause-specific premature death in individuals who self-harm, including associations with socioeconomic deprivation.Methods We undertook a cohort study of patients of all ages presenting to emergency departments in Oxford, Manchester, and Derby, UK, after self-poisoning or self-injury between Jan 1, 2000, and Dec 31, 2007. Postcodes of individuals' place of residence were linked to the Index of Multiple Deprivation 2007 in England. Mortality information was supplied by the Medical Research Information Service of the National Health Service. Patients were followed up to the end of 2009. We calculated age-standardised mortality ratios (SMRs) and years of life lost (YLL), and we tested for associations with socioeconomic deprivation.Findings 30 950 individuals presented with self-harm and were followed up for a median of 6.0 years (IQR 3.9-7.9). 1832 (6.1%) patients died before the end of follow-up. Death was more likely in patients than in the general population (SMR 3.6, 95% CI 3.5-3.8), and occurred more in males (4.1, 3.8-4.3) than females (3.2, 2.9-3.4). Deaths due to natural causes were 2-7.5 times more frequent than was expected. For individuals who died of any cause, mean YLL was 31.4 years (95% CI 30.5-32.2) for male patients and 30.7 years (29.5-31.9) for female patients. Mean YLL for natural-cause deaths was 25.9 years (25.7-26.0) for male patients and 25.5 years (25.2-25.8) for female patients, and for external-cause deaths was 40.2 years (40.0-40.3) and 40.0 years (39.7-40.5), respectively. Disease of the circulatory (13.1% in males; 13.0% in females) and digestive (11.7% in males; 17.8% in females) systems were major contributors to YLL from natural causes. All-cause mortality increased with each quartile of socioeconomic deprivation in male patients (chi(2) trend 39.6; p