Department of Epidemiology, Boston University School of Public Health, Boston, USA.
Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark.
Gen Hosp Psychiatry. 2022 Nov-Dec;79:76-117. doi: 10.1016/j.genhosppsych.2022.09.004. Epub 2022 Sep 29.
While suicide risk following psychiatric hospitalization has been studied extensively, risk following hospitalization for physical illness is less well understood. We used random forests to examine risk factors for suicide in the year following physical illness hospitalization in Denmark. In this case-cohort study, suicide cases were all individuals who died by suicide within one year of a hospitalization for a physical illness (n = 4563) and the comparison subcohort was a 5% random sample of individuals living in Denmark on January 1, 1995 who had a hospitalization for a physical illness between January 1, 1995 and December 31, 2015 (n = 177,664). We used random forests to examine identify the most important predictors of suicide stratified by sex. For women, the top 10 most important variables for random forest prediction were all related to psychiatric diagnoses. For men, many physical health conditions also appeared important to suicide prediction. Among the top 10 variables in the variable importance plot for men were influenza, injuries to the head, nervous system surgeries, and cerebrovascular diseases. Suicide prediction after a physical illness hospitalization requires comprehensive consideration of different and multiple factors for each sex.
虽然精神科住院后的自杀风险已经得到了广泛研究，但对因身体疾病住院后的风险了解较少。我们使用随机森林来研究丹麦因身体疾病住院后一年内自杀的风险因素。在这项病例对照研究中，自杀病例均为在因身体疾病住院后一年内自杀身亡的个体（n=4563），对照组是 1995 年 1 月 1 日居住在丹麦的、在 1995 年 1 月 1 日至 2015 年 12 月 31 日期间因身体疾病住院的个体的 5%随机样本（n=177664）。我们使用随机森林来按性别分层识别自杀的最重要预测因子。对于女性，随机森林预测的前 10 个最重要变量都与精神科诊断有关。对于男性，许多身体健康状况也对自杀预测很重要。在男性的变量重要性图中，前 10 个变量包括流感、头部受伤、神经系统手术和脑血管疾病。身体疾病住院后的自杀预测需要对每一种性别综合考虑不同和多种因素。
