Department of Cardiothoracic Surgery Aarhus University Hospital Aarhus N Denmark.
Unit of Clinical Biostatistics Aalborg University Hospital Aalborg Denmark.
J Am Heart Assoc. 2020 May 18;9(10):e015735. doi: 10.1161/JAHA.119.015735. Epub 2020 May 8.
Background In this nationwide study, we used the unique Danish registries to estimate the risk of suicide and deliberate self-harm in patients with congenital heart disease (CHD). Methods and Results We identified all Danish citizens receiving a diagnosis of CHD between 1977 and 2007. As a reference cohort, we randomly selected 10 citizens for each patient, matched by sex and birth year. Using the Fine and Gray competing risk regression, we estimated the cumulative incidences of suicide and self-harm, and Cox proportional regression analysis was used to compare the risk of suicide and deliberate self-harm in patients with CHD with the reference cohort. We identified 14 433 patients with CHD. Mean follow-up was 21.3 years, with a maximum follow-up of 42 years. Since the time of diagnosis, 2659 patients had died, with a median age of death of 23 years. A total of 15 patients had died by suicide, compared with 232 suicides in the reference cohort. Patients with CHD had a low and similar risk of dying by suicide when compared with the reference cohort (cause-specific hazard ratio, 0.81; 95% CI, 0.48-1.37; and subhazard ratio, 0.68; 95% CI, 0.41-1.16). We identified 336 events of self-harm among patients with CHD, and 3484 events in the reference group. The overall risk of deliberate self-harm was not increased in patients with CHD when compared with the reference group (subhazard ratio, 0.95; 95% CI, 0.85-1.06). Conclusions This is the first study to estimate the risk of suicide and deliberate self-harm in patients with CHD. We found that patients with CHD do not have an increased risk of suicide or deliberate self-harm when compared with a large reference cohort.
在这项全国性研究中，我们利用独特的丹麦登记处来估计先天性心脏病（CHD）患者的自杀和蓄意自伤风险。
我们确定了 1977 年至 2007 年间所有被诊断患有 CHD 的丹麦公民。作为参考队列，我们为每位患者随机选择了 10 名公民，按性别和出生年份匹配。使用 Fine 和 Gray 竞争风险回归估计自杀和自伤的累积发生率，并使用 Cox 比例风险回归分析比较 CHD 患者与参考队列的自杀和蓄意自伤风险。我们确定了 14433 例 CHD 患者。平均随访时间为 21.3 年，最长随访时间为 42 年。自诊断以来，共有 2659 例患者死亡，中位死亡年龄为 23 岁。共有 15 例患者死于自杀，而参考队列中有 232 例自杀。与参考队列相比，CHD 患者自杀死亡的风险较低且相似（特异性危害比，0.81；95%CI，0.48-1.37；亚危害比，0.68；95%CI，0.41-1.16）。我们确定了 336 例 CHD 患者的自伤事件，而参考组中有 3484 例。与参考组相比，CHD 患者蓄意自伤的总体风险并未增加（亚危害比，0.95；95%CI，0.85-1.06）。
这是第一项估计 CHD 患者自杀和蓄意自伤风险的研究。我们发现，与大型参考队列相比，CHD 患者自杀或蓄意自伤的风险没有增加。
