Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD 21228, USA.
Schizophr Bull. 2011 Jul;37(4):832-8. doi: 10.1093/schbul/sbp152. Epub 2009 Dec 17.
This study examined effects of cigarette smoking on mortality risk in 1213 persons aged 19-69 years with schizophrenia-related psychotic disorders admitted to State of Maryland Hospitals between 1994 and 2000. Inpatient medical records from 7 hospitals were reviewed to obtain demographic information, diagnosis, medication use, as well as smoking and other substance use. Social Security Death Index data were used to identify deaths in the study group between 1994 and 2004. Death records were reviewed to obtain manner of death and underlying disorders. Of the 1213, 55% were smokers and 71% abused substances. There was an age × smoking interaction (χ(2) = 14.6, df = 1, P = .0001) for mortality, with estimated hazard ratios (HRs) for smokers vs nonsmokers of 2.1 among 35- to 54-year olds and HR of 0.7 among those aged 55-69 years. Five- and 10-year mortality rates for smokers aged 35-54 years were 7.0% and 14.2%, compared with 3.3% and 10.0% for nonsmokers, respectively (χ(2) = 5.53, df = 1, P = .019). Cardiac causes were identified in 43% of deaths in smokers but only 19% of deaths in nonsmokers (P < .006). For those aged 35-54 years, the odds of cardiac related death was increased by 12 fold in smokers relative to nonsmokers (HR = 12.4, χ(2) = 12.0, df = 1, P = .0005). Among people aged 35-54 years, those smoking greater than one pack daily have a significantly increased total mortality risk (HR = 2.7) vs nonsmokers. Cigarette smoking, particularly in people aged 35-54 years, contributes to an increased risk of death. Greater smoking severity significantly increases this risk. Smoking cessation in people with schizophrenia deserves significant attention.
这项研究调查了 1994 年至 2000 年间在马里兰州医院住院的 1213 名年龄在 19 至 69 岁之间的精神分裂症相关精神病患者的吸烟对死亡率的影响。对来自 7 家医院的住院病历进行了回顾,以获取人口统计学信息、诊断、用药情况以及吸烟和其他物质使用情况。利用社会保障死亡指数数据确定了研究组在 1994 年至 2004 年间的死亡情况。审查死亡记录以确定死亡方式和潜在疾病。在 1213 名患者中,55%为吸烟者,71%滥用物质。死亡率存在年龄×吸烟的交互作用(卡方值=14.6,自由度=1,P=0.0001),35 至 54 岁的吸烟者与不吸烟者的估计危害比(HR)为 2.1,而 55 至 69 岁的吸烟者 HR 为 0.7。35 至 54 岁的吸烟者 5 年和 10 年死亡率分别为 7.0%和 14.2%,而不吸烟者分别为 3.3%和 10.0%(卡方值=5.53,自由度=1,P=0.019)。在吸烟者中,43%的死亡归因于心脏原因,而不吸烟者中只有 19%(P<0.006)。对于 35 至 54 岁的人群,与不吸烟者相比,吸烟者死于心脏相关疾病的风险增加了 12 倍(HR=12.4,卡方值=12.0,自由度=1,P=0.0005)。在 35 至 54 岁的人群中,每日吸烟超过一包的人总死亡率明显高于不吸烟者(HR=2.7)。吸烟,尤其是在 35 至 54 岁的人群中,会增加死亡风险。吸烟程度越严重,风险就越大。精神分裂症患者的戒烟值得高度关注。