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精神健康消费者的自然死因死亡率:一项回顾性队列研究,跨度 10 年。

Natural cause mortality of mental health consumers: A 10-year retrospective cohort study.

机构信息

North West Area Mental Health Service, NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

出版信息

Int J Ment Health Nurs. 2021 Apr;30(2):390-400. doi: 10.1111/inm.12797. Epub 2020 Oct 9.

DOI:10.1111/inm.12797
PMID:33035405
Abstract

People with mental illness have substantially lower life expectancy than the general population, with mortality from natural causes most commonly attributed to cardiovascular diseases. The study aim was to identify characteristics of consumers who died of natural causes between 2009 and 2018 at one of Australia's largest publicly funded mental health services. Data were collected with a retrospective medical record review of 102 consumers. Mean mortality age was 52.4 years (SD = 10.7) (with females 51.9 years [SD = 12.0], and males 52.7 years [SD = 9.9]), which was more than 30 years lower than the Australian population. Cardiovascular diseases were the most frequent mortality cause (39%), followed by respiratory conditions (23%), cancers (20%), and all other causes (19%). Sixty (61%) consumers had at least three co-occurring physical health conditions. Seventy-five (74%) smoked tobacco. Consumers who died from cardiovascular diseases were less likely to attend specialist medical follow-up for their condition (P = 0.004), and more likely to die at home (P = 0.001). Consumers whose mortality age was above 55 years were more likely to have three co-occurring physical health conditions (P = 0.034). Consumers whose mortality age was below 55 years were more likely to have sub-optimal nutritional intake (P = 0.014) and higher body mass index (P = 0.008). There is a critical need to close the life expectancy gap for consumers. This requires dedicated focus on reducing mortality risk due to modifiable clinical characteristics which lead to consumer mortality. Mental health nurses play a key role in helping reduce consumers' mortality and morbidity risk through prevention and early intervention strategies.

摘要

精神疾病患者的预期寿命明显低于普通人群,导致其自然死亡的最常见原因是心血管疾病。本研究旨在确定澳大利亚最大的公共资助精神卫生服务机构之一在 2009 年至 2018 年间因自然原因死亡的消费者的特征。通过对 102 名消费者的回顾性病历审查收集数据。平均死亡年龄为 52.4 岁(标准差=10.7)(女性 51.9 岁[标准差=12.0],男性 52.7 岁[标准差=9.9]),比澳大利亚人口低 30 多岁。心血管疾病是最常见的死亡原因(39%),其次是呼吸系统疾病(23%)、癌症(20%)和其他所有原因(19%)。60 名(61%)消费者至少同时患有三种并存的身体健康状况。75 名(74%)消费者吸烟。死于心血管疾病的消费者更不可能接受该疾病的专科医疗随访(P=0.004),更有可能在家中死亡(P=0.001)。死亡年龄超过 55 岁的消费者更有可能同时患有三种并存的身体健康状况(P=0.034)。死亡年龄低于 55 岁的消费者更有可能存在营养摄入不足(P=0.014)和更高的体重指数(P=0.008)的情况。迫切需要缩小消费者的预期寿命差距。这需要专门关注降低导致消费者死亡的可改变临床特征的死亡率风险。精神健康护士在通过预防和早期干预策略帮助降低消费者的死亡率和发病率风险方面发挥着关键作用。

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