自杀未遂后 1 年内的自杀和全因死亡率。

Suicide and All-Cause Mortality Within 1 Year After a Suicide Attempt in the VigilanS Cohort.

机构信息

Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog-Lille Neuroscience & Cognition, F-59000, France.

Corresponding Author: Alice Demesmaeker, MD, MSC, Hôpital Fontan, CHU de Lille, F-59037, Lille cedex, France (

出版信息

J Clin Psychiatry. 2023 Sep 11;84(6):22m14520. doi: 10.4088/JCP.22m14520.

Abstract

Obtaining better knowledge on the outcomes of patients who attempt suicide is crucial for suicide prevention. The aim of our study was to determine the causes of death 1 year after a suicide attempt (SA) in the VigilanS program, mortality rates, and risk factors associated with any cause of death and suicide. A prospective cohort of 7,406 people who had attempted suicide between January 1, 2017, and December 31, 2018, was included in the study. The vital status of each participant was sought, and the cause of death was established through a phone call to their general practitioner or psychiatrist. Second, the relationship between sociodemographic and clinical factors and death by suicide within 1 year of an SA was assessed using a multivariable Cox model. At 1 year, 125 (1.7%) participants had died, 77 of whom died by suicide. Half of the deaths occurred within the first 4 months after an SA. Hanging (20.3%; 24/125) and self-poisoning (19.5%; 23/125) were the methods the most often used for suicide. We demonstrated that male sex (HR = 1.79 [1.13-2.82],  = .01) and being 45 years of age or older (between 45 and 64 years old, HR = 2.08 [1.21-3.56],  < .01; 65 years or older, HR = 5.36 [2.72-10.54],  < .01) were associated with a higher risk of death by suicide 1 year after an SA and that being younger than 25 years was associated with a lower risk (HR = 0.22 [0.07-0.76],  = .02). One out of 100 people who attempted suicide died by suicide within 1 year after an SA. Greater vigilance is required in the first months following an SA, especially for males older than 45 years. ClinicalTrials.gov identifier: NCT03134885.

摘要

获得关于自杀未遂患者结局的更好认识对于预防自杀至关重要。我们的研究目的是确定 VigilanS 计划中自杀未遂(SA)后 1 年的死因、死亡率以及与任何死因和自杀相关的危险因素。 该研究纳入了 2017 年 1 月 1 日至 2018 年 12 月 31 日期间尝试自杀的 7406 名患者的前瞻性队列。我们通过电话联系参与者的全科医生或精神科医生来寻找每个参与者的生命状态,并确定死因。其次,使用多变量 Cox 模型评估 SA 后 1 年内与自杀相关的社会人口学和临床因素与死亡之间的关系。 1 年后,125(1.7%)名参与者死亡,其中 77 人自杀。一半的死亡发生在 SA 后 4 个月内。上吊(20.3%;24/125)和自服毒物(19.5%;23/125)是最常被用来自杀的方法。我们证明,男性(HR=1.79 [1.13-2.82],  = .01)和 45 岁或以上(45-64 岁,HR=2.08 [1.21-3.56],  < .01;65 岁或以上,HR=5.36 [2.72-10.54],  < .01)与 SA 后 1 年内自杀死亡风险较高相关,而年龄小于 25 岁与自杀死亡风险较低相关(HR=0.22 [0.07-0.76],  = .02)。 在 SA 后 1 年内,每 100 名自杀未遂者中就有 1 人自杀死亡。在 SA 后最初几个月需要更加警惕,特别是对于年龄大于 45 岁的男性。 临床试验注册号:NCT03134885。

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