Military veteran mortality following a survived suicide attempt

BMC Public Health

Research Article

Therese S Richmond¹  Douglas J Wiebe²  Janet Weiner³  Joseph Conigliaro⁴ 

[1] Behavioral and Health Systems Department, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA;Department of Biostatistics and Epidemiology, University of Pennsylvania, 902 Blockley Hall, 423 Guardian Drive, 19104, Philadelphia, PA, USA;Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA;NYU-HHC Clinical and Translational Science Institute and Division of General Internal Medicine, New York University School of Medicine, New York, NY, USA;

关键词: Suicide Attempt;    Veteran Affair;    Post Traumatic Stress Disorder;    Standardize Mortality Rate Ratio;    Suicide Prevention;   

DOI  :  10.1186/1471-2458-11-374

 received in 2011-02-14, accepted in 2011-05-23,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundSuicide is a global public health problem. Recently in the U.S., much attention has been given to preventing suicide and other premature mortality in veterans returning from Iraq and Afghanistan. A strong predictor of suicide is a past suicide attempt, and suicide attempters have multiple physical and mental comorbidities that put them at risk for additional causes of death. We examined mortality among U.S. military veterans after hospitalization for attempted suicide.MethodsA retrospective cohort study was conducted with all military veterans receiving inpatient treatment during 1993-1998 at United States Veterans Affairs (VA) medical facilities following a suicide attempt. Deaths occurring during 1993-2002, the most recent available year at the time, were identified through VA Beneficiary and Records Locator System data and National Death Index data. Mortality data for the general U.S. adult population were also obtained from the National Center for Health Statistics. Comparisons within the veteran cohort, between genders, and against the U.S. population were conducted with descriptive statistics and standardized mortality ratios. The actuarial method was used estimate the proportion of veterans in the cohort we expect would have survived through 2002 had they experienced the same rate of death that occurred over the study period in the U.S. population having the age and sex characteristics.ResultsDuring 1993-1998, 10,163 veterans were treated and discharged at a VA medical center after a suicide attempt (mean age = 44 years; 91% male). There was a high prevalence of diagnosed alcohol disorder or abuse (31.8%), drug dependence or abuse (21.8%), psychoses (21.2%), depression (18.5%), and hypertension (14.2%). A total of 1,836 (18.1%) veterans died during follow up (2,941.4/100,000 person years). The cumulative survival probability after 10 years was 78.0% (95% CI = 72.9, 83.1). Hence the 10-year cumulative mortality risk was 22.0%, which was 3.0 times greater than expected. The leading causes overall were heart disease (20.2%), suicide (13.1%), and unintentional injury (12.7%). Whereas suicide was the ninth leading cause of death in the U.S. population overall (1.8%) during the study period, suicide was the leading and second leading cause among women (25.0%) and men (12.7%) in the cohort, respectively.ConclusionsVeterans who have attempted suicide face elevated risks of all-cause mortality with suicide being prominent. This represents an important population for prevention activities.

【 授权许可】

Unknown   
© Weiner et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.