Veterans Affairs Medical Center, White River Junction VT, USA; Geisel School of Medicine at Dartmouth College, Hanover, NH, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon NH, USA.
Veterans Affairs Medical Center, White River Junction VT, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon NH, USA.
Psychiatry Res. 2019 Mar;273:247-251. doi: 10.1016/j.psychres.2019.01.040. Epub 2019 Jan 12.
The relationship between three markers of chronic hypoxia (altitude, smoking and chronic obstructive pulmonary disease (COPD)) and suicide risk has not been well-studied. We conducted a population-based cohort study evaluating the association between chronic hypoxia and suicide risk. Patients entered the cohort in their first year with a documented healthcare encounter and remained in the cohort until their death or the end of the study period. Generalized estimating equation (GEE) methodology was used to assess the association between suicide and three risk markers of chronic hypoxia. Findings were summarized using odds ratio (OR) and 95% confidence intervals (CI). Among the 9,620,944 patients in the cohort, there were 22,403 suicide deaths. There was a statistically significant progression of suicide risk as altitude rose in increments of 1000 m (OR: 1.22). There was a strong association between the number of hypoxic conditions and the odds of suicide. Patients with three markers of chronic hypoxia was nearly four times more likely to die by suicide than patients with no markers (OR: 3.96). Chronic hypoxia is a risk factor for suicide and having multiple indicators of hypoxia confers a greater risk for suicide, indicating a dose-response relationship.
慢性缺氧（海拔、吸烟和慢性阻塞性肺疾病（COPD））的三个标志物与自杀风险之间的关系尚未得到充分研究。我们进行了一项基于人群的队列研究，评估慢性缺氧与自杀风险之间的关系。患者在有记录的医疗保健就诊的第一年进入队列，并在死亡或研究期结束前留在队列中。广义估计方程（GEE）方法用于评估自杀与慢性缺氧的三个风险标志物之间的关联。使用优势比（OR）和 95%置信区间（CI）总结结果。在队列中的 9620944 名患者中，有 22403 人自杀死亡。随着海拔每升高 1000 米，自杀风险呈统计学显著上升（OR：1.22）。缺氧情况的数量与自杀的几率之间存在很强的关联。与没有标志物的患者相比，有三个慢性缺氧标志物的患者自杀的可能性几乎高出四倍（OR：3.96）。慢性缺氧是自杀的一个危险因素，有多个缺氧指标会增加自杀的风险，表明存在剂量反应关系。
