Mujkanovic Jasmin, Warming Peder Emil, Kessing Lars Vedel, Køber Lars Valeur, Winkel Bo Gregers, Lynge T H, Tfelt-Hansen Jacob
Department of Cardiology, Rigshospitalet Hjertecentret, Kobenhavn, Hovedstaden, Denmark
Department of Forensic Medicine, University of Copenhagen Department of Forensic Medicine, Kobenhavn, Region Hovedstaden, Denmark.
Heart. 2024 Nov 19;110(23):1365-1371. doi: 10.1136/heartjnl-2024-324092.
Patients with psychiatric disorders have increased all-cause mortality compared with the general population. Previous research has shown that there is a fourfold increased risk of sudden cardiac death (SCD) among the young.
To investigate the incidence of SCD in patients with psychiatric disorders aged 18-90 years in the Danish population by systematically reviewing all deaths in 1 year.
We examined all deaths in Denmark among residents aged 18-90 years in 2010 by reviewing death certificates and autopsy reports. All deaths were categorised as non-SCD or SCD based on the available information. Psychiatric disorder was defined according to International Classification of Diseases, 10th revision criteria or by redemption of a prescription for psychotropic medication within 1 year.
Of 4.3 million residents in 2010, we observed 45 703 deaths, of which 6002 were due to SCD. Overall, the incidence rate ratio of SCD was 1.79-6.45 times higher among patients with psychiatric disorders than in the general population and was age dependent (p<0.001 across all age groups). When adjusting for age, sex and comorbidities, psychiatric disorders were independently associated with SCD, with a HR of 2.31 (2.19 to 2.43, p<0.001), and HR was highest among patients with schizophrenic disorders, with a HR of 4.51 (3.95 to 5.16, p <0.001). Furthermore, 18-year-old patients with a psychiatric disorder had an expected 10-year excess loss of life. Patients aged 18-40 with a psychiatric disorder had 13% of excess life years lost caused by SCD.
In this study, the rate of SCD in patients with psychiatric disorders is higher across all age groups than in the general population. Having a psychiatric disorder is independently associated with SCD. Patients with schizophrenic disease had the highest rates of SCD. Life expectancy for an 18-year old with a psychiatric disorder is estimated to be 10 years shorter in comparison with those without this disorder.
与普通人群相比，精神疾病患者的全因死亡率有所上升。先前的研究表明，年轻人心脏性猝死（SCD）的风险增加了四倍。
通过系统回顾丹麦人群中1年内所有死亡病例，调查18 - 90岁精神疾病患者的SCD发生率。
我们通过查阅死亡证明和尸检报告，对2010年丹麦18 - 90岁居民的所有死亡病例进行了检查。根据现有信息，将所有死亡病例分为非SCD或SCD。精神疾病根据《国际疾病分类》第10版标准定义，或根据1年内精神药物处方的领取情况定义。
在2010年的430万居民中，我们观察到45703例死亡，其中6002例死于SCD。总体而言，精神疾病患者的SCD发病率比在普通人群中高1.79 - 6.45倍，且与年龄相关（所有年龄组p<0.001）。在调整年龄、性别和合并症后，精神疾病与SCD独立相关，风险比（HR）为2.31（2.19至2.43，p<0.001），其中精神分裂症患者的HR最高，为4.51（3.95至5.16，p<0.001）。此外，患有精神疾病的18岁患者预期10年寿命损失过多。18 - 40岁患有精神疾病的患者因SCD导致的生命年损失过多达13%。
在本研究中，各年龄组精神疾病患者的SCD发生率均高于普通人群。患有精神疾病与SCD独立相关。精神分裂症患者的SCD发生率最高。估计患有精神疾病的18岁患者与未患该疾病的患者相比，预期寿命短10年。
