Hsu Mei-Chi, Ouyang Wen-Chen
Department of Nursing, I-Shou University, Kaohsiung City 82445, Taiwan.
Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan City 71742, Taiwan.
Healthcare (Basel). 2021 May 7;9(5):545. doi: 10.3390/healthcare9050545.
Persons with schizophrenia are at greater risk of developing subsequent medical conditions. To date, few studies have examined comprehensively the risks, mortality and survival rates in schizophrenia and subsequent dyslipidemia over different time periods. The objective of this study was to evaluate the occurrence of subsequent dyslipidemia after the diagnosis of schizophrenia, and factors associated with mortality and survival rate in patients with schizophrenia. We used a population-based cohort from Taiwan National Health Insurance Research Database, to investigate in patients whom were first diagnosed with schizophrenia during the period from 1997 through 2009, the risk of subsequent dyslipidemia during follow-up. Cumulative incidences and hazard ratios after adjusting for competing mortality risks were calculated. A total of 20,964 eligible patients were included. Risks (i.e., comorbidity) and protective factors (i.e., statin use) have significant impacts on mortality. The mortality exhibits a U-shaped pattern by age. After 50, the risk of death increases with age. Risk of mortality before 50 increases with a decrease in age. Risks differed by the duration time to subsequent dyslipidemia after schizophrenia. Mean duration was 63.55 months in the survive group, and 43.19 months in the deceased group. The 5-, 10-, and 15-year survival rates for patients with schizophrenia and subsequent dyslipidemia were 97.5, 90, and 79.18%, respectively. Early occurrence of subsequent dyslipidemia is associated with increased overall mortality in patients with schizophrenia.
精神分裂症患者患后续躯体疾病的风险更高。迄今为止,很少有研究全面考察精神分裂症及后续血脂异常在不同时间段的风险、死亡率和生存率。本研究的目的是评估精神分裂症诊断后后续血脂异常的发生情况,以及与精神分裂症患者死亡率和生存率相关的因素。我们使用了来自台湾国民健康保险研究数据库的基于人群的队列,调查1997年至2009年期间首次诊断为精神分裂症的患者在随访期间发生后续血脂异常的风险。计算了调整竞争性死亡风险后的累积发病率和风险比。总共纳入了20964名符合条件的患者。风险因素(即合并症)和保护因素(即使用他汀类药物)对死亡率有显著影响。死亡率随年龄呈U形模式。50岁以后,死亡风险随年龄增加而增加。50岁之前,死亡风险随年龄降低而增加。精神分裂症后至后续血脂异常的持续时间不同,风险也不同。存活组的平均持续时间为63.55个月,死亡组为43.19个月。患有精神分裂症及后续血脂异常的患者5年、10年和15年生存率分别为97.5%、90%和79.18%。精神分裂症患者后续血脂异常的早期发生与总体死亡率增加相关。