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中国精神科住院患者的死亡率:一项全国性调查。

Mortality among psychiatric inpatients in China: A national survey.

作者信息

Wu Xiaodong, Xia Lei, Yang Yating, Zhang Ling, Li Mengdie, Liu Tingfang, Liu Yuanli, Cotes Robert O, Jiang Feng, Tang Yi-Lang, Liu Huanzhong

机构信息

Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China.

School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

出版信息

Asian J Psychiatr. 2022 Nov;77:103262. doi: 10.1016/j.ajp.2022.103262. Epub 2022 Sep 17.

Abstract

BACKGROUND

Patients with mental disorders are at increased risk of premature mortality. Psychiatric inpatients are a particularly vulnerable population, yet data on the mortality rate and causes of death among psychiatric inpatients in a national sample are scarce.

METHODS

We analyzed data collected from patients who died during psychiatric hospitalization in 2019 and 2020 from 41 psychiatric hospitals in China.

RESULTS

In total, 719 inpatients died over the study period. There were more deaths in 2019 (N = 409, 56.9%) compared to 2020 (N = 310, 43.1%). The mean age was 73.3 ± 16.5 years old, with males significantly younger than females (71.5 ± 16.9 vs. 75.9 ± 15.6, p < 0.001). Sudden death accounted for 11.5% of all deaths. The cause was unknown for 31.2% of cases. Among those with known causes of death, respiratory disorders were most common in patients with psychotic disorders (41.9%) and mood disorders (29.8%). Suicide accounted for 17.0% of deaths in patients with mood disorders.

CONCLUSION

Patients who died during psychiatric hospitalization were overall older (>70 years), and more than one in ten died due to sudden death. While respiratory disorders accounted for the largest proportion of known causes, the causes were unknown in nearly one-third. Death due to suicide, a preventable cause, remained common among patients with mood disorders. Evidence-based interventions should be implemented.

摘要

背景

精神障碍患者过早死亡的风险增加。精神科住院患者是一个特别脆弱的群体,但关于全国样本中精神科住院患者死亡率和死因的数据却很稀少。

方法

我们分析了2019年和2020年在中国41家精神病医院精神科住院期间死亡患者的数据。

结果

在研究期间,共有719名住院患者死亡。2019年死亡人数更多(N = 409,56.9%),而2020年为310人(43.1%)。平均年龄为73.3±16.5岁,男性明显比女性年轻(71.5±16.9对75.9±15.6,p < 0.001)。猝死占所有死亡人数的11.5%。31.2%的病例死因不明。在已知死因的患者中,呼吸系统疾病在精神障碍患者(41.9%)和情绪障碍患者(29.8%)中最为常见。自杀占情绪障碍患者死亡人数的17.0%。

结论

在精神科住院期间死亡的患者总体年龄较大(>70岁),超过十分之一的患者死于猝死。虽然呼吸系统疾病在已知死因中占比最大,但近三分之一的死因不明。自杀作为一种可预防的死因,在情绪障碍患者中仍然很常见。应实施基于证据的干预措施。

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