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精神分裂症患者发生重大感染的风险因素。一项全国性丹麦登记研究。

Risk factors of major infections in schizophrenia. A nationwide Danish register study.

机构信息

The Focused Research Unit of Psychiatry, Department of Psychiatry, Aabenraa, Denmark; University of Southern Denmark, Winsløwparken 19.3, Odense C-DK 5000, Department of Regional Health Research, Faculty of Health Sciences, Denmark.

University of Southern Denmark, Winsløwparken 19.3, Odense C-DK 5000, Department of Regional Health Research, Faculty of Health Sciences, Denmark; The Focused Research Group of Neurology, Department of Neurology, Hospital of Southern Jutland, Sønderborg, Denmark.

出版信息

J Psychosom Res. 2019 Jun;121:60-67. doi: 10.1016/j.jpsychores.2019.04.003. Epub 2019 Apr 13.

Abstract

BACKGROUND

Risk of infections is elevated in patients with schizophrenia. Predicting their occurrence is essential, as infections in this group of patients are associated with prolonged hospital admission and increased mortality. The objective of the current investigation was to identify the potential risk factors of major infection after diagnosis with schizophrenia.

METHODS

This national prospective observational cohort study included 7788 people with schizophrenia born in Denmark between 1975 and 1990. Socio-demographic, psychiatric and health related data were obtained from Danish national registers. The Cox regression model was used for data analyses. Crude and adjusted hazard ratios (HRs) with 95% confidence intervals (95%CIs) are presented.

RESULTS

The most significant risk factors associated with the development of major infections included young age, female gender, medical comorbidity and substance abuse. A history of treatment with antipsychotics preceding the diagnosis was negatively associated with such morbidity.

CONCLUSION

This study reports several factors that might increase the risk of infections in individuals with schizophrenia. Early intervention towards infections should be considered in the subpopulation of schizophrenia patients who are at increased risk of infections.

摘要

背景

精神分裂症患者的感染风险升高。预测感染的发生至关重要,因为此类患者的感染与住院时间延长和死亡率增加有关。本研究旨在确定诊断为精神分裂症后发生重大感染的潜在危险因素。

方法

本项全国性前瞻性观察性队列研究纳入了 1975 年至 1990 年间在丹麦出生的 7788 名精神分裂症患者。从丹麦国家登记处获取了社会人口统计学、精神病学和与健康相关的数据。采用 Cox 回归模型进行数据分析。给出了未经调整和调整后的风险比(HR)及其 95%置信区间(95%CI)。

结果

与重大感染发展相关的最显著危险因素包括年龄较小、女性、合并症和药物滥用。在诊断之前接受抗精神病药物治疗的病史与这种发病率呈负相关。

结论

本研究报告了一些可能增加精神分裂症患者感染风险的因素。对于感染风险较高的精神分裂症患者亚群,应考虑早期针对感染的干预措施。

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