■因自杀未遂而到医院就诊的人有反复自杀行为的高风险,然而,关于反复自杀行为导致死亡的程度的数据很少。
■这项回顾性队列研究基于中国农村县的综合医院自残登记系统。与试图自杀的人联系并随访长达8年。随访的主要结果是:1)自杀死亡,2)非致命自杀企图,3)自杀行为,包括自杀死亡和非致命企图。入射密度,相关性,并估计了反复自杀行为的病死率。
■共有1086个人(三分之二的女性,平均年龄40.6岁),并确定并随访了向医院提出的自杀未遂(指数尝试),大多数指标尝试通过农药摄入(79%)。过度随访,108个人(69名女性,39名男性),包括34例自杀死亡(21例女性,13名男性),产生29.3%的高病死率。随访期间,总体和随访第一年的自杀死亡率也很高(每100,000人年846.7和1787.2)。过度随访,农药是重复自杀行为的最常见方法(47/116),其病死率高于其他方法(46.8%vs17.4%,χ2=11.68,P<0.001)。与先前文献报道的发生率相比,反复自杀行为和非致命企图的发生率较低。
■与以前的研究相比,中国农村队列中重复自杀行为的发生率较低。然而,随访期间自杀死亡率很高,这一结果是由自杀行为的高病死率驱动的,可归因于农药的普遍使用。减少使用农药的自杀行为是中国农村预防自杀的关键目标。
■北京市高级公共卫生研究员培训计划,北京市医院管理局临床医学发展专项资金支持,和北京医院管理局的晋升计划。
UNASSIGNED: Individuals presenting to hospital due to suicide attempt are at high risk for repeated suicidal act, yet there are meager data on the extent to which repeated suicidal acts result in death.
UNASSIGNED: This retrospective cohort study was based on a general hospital self-harm register system in a rural county in China. Identified individuals who attempted suicide were contacted and followed up for up to 8 years. Main outcomes over follow-up were: 1) suicide death, 2) nonlethal suicide attempt, and 3) suicidal acts including suicide death and nonlethal attempt. Incidence densities, correlates, and
case fatality of repeated suicidal acts were estimated.
UNASSIGNED: A total of 1086 individuals (two-thirds females, mean age 40.6 years) with a suicide attempt presenting to hospital (index attempt) were identified and followed up, with most of the index attempts by pesticide ingestion (79%). Over follow-up, there were 116 suicidal acts carried out by 108 individuals (69 females, 39 males), including 34 suicide deaths (21 females, 13 males), yielding a high
case-fatality of 29.3%. During follow-up, suicide death rates were also high overall and in the first year of follow-up (846.7 and 1787.2 per 100,000 person years). Over follow-up, pesticide was the most common method (47/116) of repeated suicidal act and yielded a higher
case-fatality than other methods (46.8% vs 17.4%, χ2 = 11.68, P < 0.001). The incidence densities of repeated suicidal acts and nonlethal attempts were low compared to rates reported in previous literature.
UNASSIGNED: Incidence densities of repeated suicidal acts in a rural China cohort were low compared to previous studies. However, rates of suicide deaths over follow-up were high, a result driven by the high
case-fatality of suicidal acts and attributable to the common use of pesticides. Reducing suicidal acts with pesticides is a key target for suicide prevention in rural China.
UNASSIGNED: Beijing Municipal High Rank Public Health Researcher Training Program, Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support, and Beijing Hospitals Authority\'s Ascent Plan.