Brenn Tormod, Ytterstad Elinor
Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway.
Department of Mathematics and Statistics, UiT The Arctic University of Norway, N-9037 Tromsø, Norway.
Prev Med. 2016 Aug;89:251-256. doi: 10.1016/j.ypmed.2016.06.019. Epub 2016 Jun 14.
This paper examines the short-term risk of cause-specific death following widowhood.
We followed all individuals registered as married in Norway in 1975 for marital status and mortality until 2006. Widowed individuals were followed for mortality for 7years following widowhood. Causes of death were categorized into five cause-groups. Life tables were used in survival analyses.
Deaths among the widowed were most frequent in the week following widowhood. In this week and compared to married individuals, there were more deaths including those from malignant cancer in men (hazard ratio (HR) of 1.51; 95% CI: 1.12, 1.89), from external causes in men (HR=3.64; 95% CI: 2.01, 5.28), and from respiratory diseases (HR=2.18; 95% CI: 1.52, 2.84 in men and HR=3.18; 95% CI: 2.26, 4.09 in women). A majority of respiratory deaths were from pneumonia. Thereafter excess mortality among the widowed dropped gradually. Although these numbers stabilized, they were still elevated in year 7. Excess mortality was particularly high in the youngest age group considered (55-64years) and decreased with age, though more so in men than in women. Only a few more widowed individuals than expected died of a condition in the same cause-group as their spouses.
A novel finding was that excess deaths in the week following widowhood also were from cancer and respiratory diseases. Men in the youngest age group seemed most vulnerable. Prevention should be considered directly after the death of a spouse, and measures should be aimed at virtually all causes of death.
本文探讨丧偶后特定病因死亡的短期风险。
我们追踪了1975年在挪威登记结婚的所有个体的婚姻状况和死亡率,直至2006年。丧偶个体在丧偶后被追踪7年的死亡率。死亡原因被分为五个病因组。生存分析中使用了生命表。
丧偶者的死亡在丧偶后的第一周最为频繁。在这一周,与已婚个体相比,男性中包括恶性癌症导致的死亡更多(风险比(HR)为1.51;95%置信区间:1.12,1.89),男性中因外部原因导致的死亡更多(HR = 3.64;95%置信区间:2.01,5.28),以及因呼吸系统疾病导致的死亡更多(男性HR = 2.18;95%置信区间:1.52,2.84;女性HR = 3.18;95%置信区间:2.26,4.09)。大多数呼吸系统死亡是由肺炎引起的。此后,丧偶者的超额死亡率逐渐下降。尽管这些数字趋于稳定,但在第7年仍有所升高。超额死亡率在最年轻的年龄组(55 - 64岁)中尤其高,并且随着年龄增长而下降,不过男性下降幅度比女性更大。死于与配偶相同病因组疾病而死亡的丧偶者仅比预期多几例。
一个新发现是丧偶后第一周的超额死亡也来自癌症和呼吸系统疾病。最年轻年龄组的男性似乎最脆弱。应在配偶去世后直接考虑预防措施,并且措施应针对几乎所有死因。