DeVivo M J, Black K J, Richards J S, Stover S L
Department of Rehabilitation Medicine, University of Alabama, Birmingham 35294.
Paraplegia. 1991 Nov;29(9):620-7. doi: 10.1038/sc.1991.91.
A study of 9135 persons injured between 1973 and 1984 and treated at any of 13 model regional spinal cord injury (SCI) care systems was conducted. Follow-up ended December 31, 1985, by which time 50 persons had committed suicide (6.3% of deaths). Based on age-sex-race-specific rates for the general population, 10.2 suicides were expected to occur. Therefore, the standardized mortality ratio (SMR) for suicide was 4.9. The highest SMR occurred 1 to 5 years after injury. The SMR was also elevated for the first post-injury year, but was not significantly elevated after the fifth year. The SMR was significantly elevated for all neurological groups, but was highest for persons with complete paraplegia. The SMR was highest for persons aged 25 to 54 years, but was also elevated for persons aged less than 25 years. Suicide was the leading cause of death for persons with complete paraplegia and the second leading cause of death for persons with incomplete paraplegia. The most common means of committing suicide was by gunshot. These figures demonstrate the need for increased staff, patient and family awareness of this problem, and improved follow-up assessment and psychosocial support programmes.
对1973年至1984年间受伤并在13个示范区域脊髓损伤（SCI）护理系统中的任何一个接受治疗的9135人进行了一项研究。随访于1985年12月31日结束，届时有50人自杀（占死亡人数的6.3%）。根据一般人群的年龄、性别和种族特异性率，预计会发生10.2起自杀事件。因此，自杀的标准化死亡率（SMR）为4.9。最高的SMR发生在受伤后1至5年。受伤后的第一年SMR也有所升高，但在第五年后没有显著升高。所有神经学组的SMR均显著升高，但完全性截瘫患者的SMR最高。25至54岁人群的SMR最高，但25岁以下人群的SMR也有所升高。自杀是完全性截瘫患者的主要死因，是不完全性截瘫患者的第二大死因。最常见的自杀方式是枪击。这些数字表明，需要提高工作人员、患者和家属对这一问题的认识，并改善随访评估和社会心理支持计划。
