Department of Social Welfare, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.
National Pension Research Institute, Jeonju, Republic of Korea.
Int J Public Health. 2017 Dec;62(9):989-996. doi: 10.1007/s00038-017-0966-5. Epub 2017 Mar 18.
This longitudinal study examines to what extent the risk of mortality-all-cause, natural death, suicide, and unintentional injury mortality-differs by types and severity of disabilities as well as disability status.
Data were the National Sample Cohort of 1,025,340 individuals in South Korea followed from 2002 to 2013. Cox regression with time-variant variables was used to estimate the hazard ratio of mortality by disability.
Individuals with disabilities had a higher risk of mortality compared to those without (HR 1.84, 95% CI 1.80-1.88 for natural death; HR 1.83, 95% CI 1.64-2.03 for suicide; HR 1.54, 95% CI 1.38-1.71 for unintentional injury). All types of disability were associated with an increased risk of natural death. Individuals with mental disability were the highest risk group for suicide (HR 7.14, 95% CI 5.31-9.60). People defined as having severe disability had an elevated risk for all categories of mortality.
Disabilities are important markers of high risk of mortality. Findings call for actions to reduce mortality risk of people with disabilities, including preventing suicidal behaviors of those with mental disability.
本纵向研究旨在探讨不同类型和严重程度的残疾以及残疾状况对全因死亡率、自然死亡率、自杀率和非故意伤害死亡率的影响程度。
数据来自韩国的全国样本队列，共纳入 1,025,340 名个体，随访时间从 2002 年至 2013 年。采用时变变量的 Cox 回归分析来估计残疾与死亡率的风险比。
与无残疾者相比，残疾者的死亡率更高（自然死亡的风险比为 1.84，95%可信区间为 1.80-1.88；自杀的风险比为 1.83，95%可信区间为 1.64-2.03；非故意伤害的风险比为 1.54，95%可信区间为 1.38-1.71）。所有类型的残疾都与自然死亡风险增加相关。精神残疾者自杀风险最高（风险比为 7.14，95%可信区间为 5.31-9.60）。被定义为严重残疾的人所有类别的死亡率都升高。
残疾是死亡率高的重要标志。这些发现呼吁采取行动降低残疾者的死亡率风险，包括预防精神残疾者的自杀行为。
