Elshanbary Alaa Ahmed, Zaazouee Mohamed Sayed, Hasan Sara Mohamed, Abdel-Aziz Walid
Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
Psychooncology. 2021 Dec;30(12):2067-2076. doi: 10.1002/pon.5804. Epub 2021 Aug 28.
This study aims to investigate the risk factors for suicide in patients with gastric adenocarcinoma (GAC) to recognize patients at higher risk who require special mental health care.
Patients' data were collected from the Surveillance, Epidemiology, and End Results database from 1975 to 2016. The relationships among categorical variables were assessed using Person's chi-square test. Standardized mortality ratio was used to compare ratios of suicide and other causes of death between the US population and adenocarcinoma patients. Cox regression and Kaplan-Meier were used for multivariate and univariate analyses. The probability of suicide was assessed using the binary regression analysis. All analyses were conducted using SPSS software.
Among 59,580 patients included in this study, 86 died due to suicide. The mean survival months was higher in patients <50 years (81.759) than in patients ≥50 years (42.961), and in females (49.116) than in males (44.591). The multivariate analysis showed a higher suicide mortality risk in divorced patients (HR = 2.461; 95% CI [1.015, 5.966], p = 0.046), patients not recommended for surgery (HR = 1.997; 95% CI [1.08, 3.694], p = 0.027) and patients with distant stage of the disease (HR = 2.68; 95% CI [1.395, 5.147], p = 0.003). Females had a lower suicide mortality risk (HR = 0.124; 95% CI [0.045, 0.314], p < 0.001).
GAS predisposes to suicide. The risk is higher in patients who are males, divorced, not recommended for surgery, or have a distant spread of the disease.
本研究旨在调查胃腺癌（GAC）患者自杀的危险因素，以识别需要特殊心理健康护理的高风险患者。
收集1975年至2016年监测、流行病学和最终结果数据库中的患者数据。使用Person卡方检验评估分类变量之间的关系。标准化死亡率用于比较美国人群与腺癌患者的自杀率和其他死因比率。Cox回归和Kaplan-Meier用于多变量和单变量分析。使用二元回归分析评估自杀概率。所有分析均使用SPSS软件进行。
本研究纳入的59580例患者中，86例死于自杀。年龄<50岁的患者平均生存月数（81.759）高于年龄≥50岁的患者（42.961），女性患者（49.116）高于男性患者（44.591）。多变量分析显示，离婚患者（HR = 2.461；95% CI [1.015, 5.966]，p = 0.046）、不建议手术的患者（HR = 1.997；95% CI [1.08, 3.694]，p = 0.027）和疾病远处转移的患者（HR = 2.68；95% CI [1.395, 5.147]，p = 0.003）自杀死亡风险较高。女性自杀死亡风险较低（HR = 0.124；95% CI [0.045, 0.314]，p < 0.001）。
胃腺癌易引发自杀。男性、离婚、不建议手术或疾病远处转移的患者风险更高。
