青年静脉血栓栓塞后使用精神药物。一项全国性队列研究。

Use of psychotropic drugs following venous thromboembolism in youth. A nationwide cohort study.

作者信息

Højen Anette Arbjerg, Gorst-Rasmussen Anders, Lip Gregory Y H, Lane Deirdre A, Rasmussen Lars Hvilsted, Sørensen Erik Elgaard, Larsen Torben Bjerregaard

机构信息

Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Clinical Nursing Research Unit, Aalborg University Hospital Science and Innovation Center, Aalborg University Hospital, Aalborg, Denmark; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark.

Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark.

出版信息

Thromb Res. 2015 Apr;135(4):643-7. doi: 10.1016/j.thromres.2015.01.024. Epub 2015 Jan 24.

DOI:10.1016/j.thromres.2015.01.024

PMID:25661687

Abstract

INTRODUCTION

The mental health prognosis following a venous thromboembolism in youth has not been investigated comprehensively. Using psychotropic drug purchase as a proxy for mental health status, we investigated this issue in a large cohort of young incident venous thromboembolism patients.

METHODS

Using Danish nationwide administrative registries from the period 1997-2010, we identified 4,132 patients aged 13-33 years with a first-time venous thromboembolism diagnosis and no history of psychotropic drug usage. We sampled comparison cohort of random general population controls, matched individually in a 1:5 ratio based on sex and birth year. Participants were followed in prescription purchase registries for their first psychotropic drug purchase.

RESULTS

Among young venous thromboembolism case cases, the 1-year risk of psychotropic drug purchase was 7.1% (95% confidence interval [CI] 6.3, 7.9) and the 5-year risk 22.1% (95% CI 20.7, 23.5). This was substantially higher than among population controls, with 1- and 5-year risk differences relative to the controls of 4.7% (95% CI 3.9, 5.5), and 10.8% (95% CI 9.4, 12.3), respectively. Adjustment for the effects of recent pregnancy or somatic provocations attenuated risk differences to 4.1% (95% CI 3.5, 5.1) after 1 year and 9.6% (95% CI 8.3, 11.2) after 5 years.

CONCLUSIONS

A venous thromboembolism diagnosis in youth is associated with a poorer mental health prognosis: one in five patients are prescribed psychotropic medication within the first 5 year after diagnosis.

摘要

引言

青年静脉血栓栓塞后的心理健康预后尚未得到全面研究。我们以精神药物购买作为心理健康状况的替代指标，在一大群青年静脉血栓栓塞患者队列中对这一问题进行了调查。

方法

利用丹麦1997年至2010年期间的全国行政登记数据，我们确定了4132名年龄在13至33岁之间、首次诊断为静脉血栓栓塞且无精神药物使用史的患者。我们抽取了随机的普通人群对照队列，根据性别和出生年份以1:5的比例进行个体匹配。参与者在处方购买登记处被跟踪其首次购买精神药物的情况。

结果

在青年静脉血栓栓塞病例中，购买精神药物的1年风险为7.1%（95%置信区间[CI]6.3，7.9），5年风险为22.1%（95%CI20.7，23.5）。这显著高于人群对照，相对于对照的1年和5年风险差异分别为4.7%（95%CI3.9，5.5）和10.8%（95%CI9.4，12.3）。对近期怀孕或躯体诱因的影响进行调整后，1年后风险差异降至4.1%（95%CI3.5，5.1），5年后降至9.6%（95%CI8.3，11.2）。