Chao-Han Liu1, Ji-Hung Wang2, Shu-Chuan Weng3, Yen-Huang Cheng4, Ming-Kung Yeh5, Meng-Yi Bai6, Jung-Chen Chang7. 1. Biomedical Engineering Program, Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei, Taiwan; Division of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan. 2. School of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Cardiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan. 3. Bachelor Degree Program of Golden-Age Well-Being Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan. 4. Division of Emergency Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan. 5. School of Pharmacy, National Defense Medical Center, Taiwan. 6. Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology & Adjunct Appoint to the Department of Biomedical Engineering, National Defense Medical Center, Taipei, Taiwan. Electronic address: mybai@mail.ntust.edu.tw. 7. School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: jungchenchang@ntu.edu.tw.
Abstract
BACKGROUND: The high prevalence of heart failure (HF) in developed countries imposes a substantial burden on health care resources. Depression is widely recognized as a risk factor associated with HF. This study examined the relationship between suicide and HF after controlling for depression and other comorbidities. METHODS AND RESULTS: The population comprised 52,749 adult patients who died from suicide from 2000 to 2012 and 210,996 living control subjects matched by age, sex, and residence area. Data were obtained from the Health and Welfare Data Science Center, Taiwan. Multivariable models were constructed to evaluate the relationship between HF and suicide. In the case and control groups 1624 (3.08%) and 4053 (1.92%) patients had HF, respectively, indicating that HF was associated with an increased risk of suicide (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.59-1.79). The risk of suicide was highest during the initial 6 months after HF (adjusted OR 7.04, 95% CI 5.37-9.22) and subsequently declined gradually. Among psychiatric disorders, mood disorders (adjusted OR 7.42, 95% CI 7.06-7.79) yielded the highest odds of suicide. CONCLUSIONS: The risk of suicide is higher for patients with HF than for healthy individuals without HF. This risk is particularly high during the first 6 months after HF diagnosis. This study provides strong evidence that depression is a negative prognostic factor for patients with HF and increases the risk of suicide. The results suggest that early screening and treatment for depression and suicide risk should be conducted for patients with HF.
BACKGROUND: The high prevalence of heart failure (HF) in developed countries imposes a substantial burden on health care resources. Depression is widely recognized as a risk factor associated with HF. This study examined the relationship between suicide and HF after controlling for depression and other comorbidities. METHODS AND RESULTS: The population comprised 52,749 adult patients who died from suicide from 2000 to 2012 and 210,996 living control subjects matched by age, sex, and residence area. Data were obtained from the Health and Welfare Data Science Center, Taiwan. Multivariable models were constructed to evaluate the relationship between HF and suicide. In the case and control groups 1624 (3.08%) and 4053 (1.92%) patients had HF, respectively, indicating that HF was associated with an increased risk of suicide (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.59-1.79). The risk of suicide was highest during the initial 6 months after HF (adjusted OR 7.04, 95% CI 5.37-9.22) and subsequently declined gradually. Among psychiatric disorders, mood disorders (adjusted OR 7.42, 95% CI 7.06-7.79) yielded the highest odds of suicide. CONCLUSIONS: The risk of suicide is higher for patients with HF than for healthy individuals without HF. This risk is particularly high during the first 6 months after HF diagnosis. This study provides strong evidence that depression is a negative prognostic factor for patients with HF and increases the risk of suicide. The results suggest that early screening and treatment for depression and suicide risk should be conducted for patients with HF.
Authors: William V Bobo; Euijung Ryu; Tanya M Petterson; Kandace Lackore; Yijing Cheng; Hongfang Liu; Laura Suarez; Martin Preisig; Leslie T Cooper; Veronique L Roger; Jyotishman Pathak; Alanna M Chamberlain Journal: J Comorb Date: 2020-12-24