Death by suicide and other externally caused injuries after stroke in japan (1990-2010): The japan public health center-based prospective study

Takashi Yamauchi, Masatoshi Inagaki, Naohiro Yonemoto, Motoki Iwasaki, Manami Inoue, Tatsuo Akechi, Hiroyasu Iso, Shoichiro Tsugane

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

OBJECTIVE: No large population-based prospective study has investigated the risks of suicide and death by other externally caused injuries (ECIs) among stroke patients. The purpose of this study was to examine whether stroke increases the risks of suicide and ECI deaths. METHODS: We analyzed data from the Japan Public Health Center-based Prospective Study between 1990 and 2010. Poisson regression models were used to calculate adjusted risk ratios (RR) for suicide and ECI deaths. To adjust for unmeasured confounders, case-crossover analyses of all stroke patients who died by suicide and ECIs were also performed. RESULTS: A population-based cohort of 93,027 Japanese residents was established. During the follow-up period, 4793 residents had been diagnosed as having stroke. During this period, there were 22 suicides and 53 ECI deaths among stroke patients and 490 suicides and 675 ECI deaths among those who were stroke-free. Stroke patients were at increased risk for death by suicide and ECIs within the first 5 years after a stroke (suicide: RR = 10.2, 95% confidence interval [CI] = 6.3-16.6; ECI: RR = 12.8, 95% confidence interval = 9.0-18.2). Furthermore, case-crossover analyses confirmed the results of the Poisson regression models. CONCLUSIONS: The RRs of suicide and ECI deaths within the first 5 years after a stroke were noticeably high. These findings underscore the need for clinicians and health care professionals to be aware of causes of death after a stroke and closely monitor patients during the first few poststroke years.

Original languageEnglish
Pages (from-to)452-459
Number of pages8
JournalPsychosomatic Medicine
Volume76
Issue number6
DOIs
Publication statusPublished - 2014

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Suicide
Japan
Public Health
Stroke
Prospective Studies
Wounds and Injuries
Odds Ratio
Health Centers
Confidence Intervals
Population
Cause of Death
Delivery of Health Care

Keywords

  • cohort studies
  • injuries
  • prospective studies
  • stroke
  • suicide

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology
  • Arts and Humanities (miscellaneous)
  • Developmental and Educational Psychology
  • Medicine(all)

Cite this

Death by suicide and other externally caused injuries after stroke in japan (1990-2010) : The japan public health center-based prospective study. / Yamauchi, Takashi; Inagaki, Masatoshi; Yonemoto, Naohiro; Iwasaki, Motoki; Inoue, Manami; Akechi, Tatsuo; Iso, Hiroyasu; Tsugane, Shoichiro.

In: Psychosomatic Medicine, Vol. 76, No. 6, 2014, p. 452-459.

Research output: Contribution to journalArticle

Yamauchi, Takashi ; Inagaki, Masatoshi ; Yonemoto, Naohiro ; Iwasaki, Motoki ; Inoue, Manami ; Akechi, Tatsuo ; Iso, Hiroyasu ; Tsugane, Shoichiro. / Death by suicide and other externally caused injuries after stroke in japan (1990-2010) : The japan public health center-based prospective study. In: Psychosomatic Medicine. 2014 ; Vol. 76, No. 6. pp. 452-459.
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N2 - OBJECTIVE: No large population-based prospective study has investigated the risks of suicide and death by other externally caused injuries (ECIs) among stroke patients. The purpose of this study was to examine whether stroke increases the risks of suicide and ECI deaths. METHODS: We analyzed data from the Japan Public Health Center-based Prospective Study between 1990 and 2010. Poisson regression models were used to calculate adjusted risk ratios (RR) for suicide and ECI deaths. To adjust for unmeasured confounders, case-crossover analyses of all stroke patients who died by suicide and ECIs were also performed. RESULTS: A population-based cohort of 93,027 Japanese residents was established. During the follow-up period, 4793 residents had been diagnosed as having stroke. During this period, there were 22 suicides and 53 ECI deaths among stroke patients and 490 suicides and 675 ECI deaths among those who were stroke-free. Stroke patients were at increased risk for death by suicide and ECIs within the first 5 years after a stroke (suicide: RR = 10.2, 95% confidence interval [CI] = 6.3-16.6; ECI: RR = 12.8, 95% confidence interval = 9.0-18.2). Furthermore, case-crossover analyses confirmed the results of the Poisson regression models. CONCLUSIONS: The RRs of suicide and ECI deaths within the first 5 years after a stroke were noticeably high. These findings underscore the need for clinicians and health care professionals to be aware of causes of death after a stroke and closely monitor patients during the first few poststroke years.

AB - OBJECTIVE: No large population-based prospective study has investigated the risks of suicide and death by other externally caused injuries (ECIs) among stroke patients. The purpose of this study was to examine whether stroke increases the risks of suicide and ECI deaths. METHODS: We analyzed data from the Japan Public Health Center-based Prospective Study between 1990 and 2010. Poisson regression models were used to calculate adjusted risk ratios (RR) for suicide and ECI deaths. To adjust for unmeasured confounders, case-crossover analyses of all stroke patients who died by suicide and ECIs were also performed. RESULTS: A population-based cohort of 93,027 Japanese residents was established. During the follow-up period, 4793 residents had been diagnosed as having stroke. During this period, there were 22 suicides and 53 ECI deaths among stroke patients and 490 suicides and 675 ECI deaths among those who were stroke-free. Stroke patients were at increased risk for death by suicide and ECIs within the first 5 years after a stroke (suicide: RR = 10.2, 95% confidence interval [CI] = 6.3-16.6; ECI: RR = 12.8, 95% confidence interval = 9.0-18.2). Furthermore, case-crossover analyses confirmed the results of the Poisson regression models. CONCLUSIONS: The RRs of suicide and ECI deaths within the first 5 years after a stroke were noticeably high. These findings underscore the need for clinicians and health care professionals to be aware of causes of death after a stroke and closely monitor patients during the first few poststroke years.

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