The influence of comorbid disease on premature death due to natural and unnatural causes in persons with schizophrenia
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The influence of comorbid disease on premature death due to natural and unnatural causes in persons with schizophrenia. / Kruckow, Line; Basit, Saima; Nordentoft, Merete; Banner, Jytte; Boyd, Heather Allison.
I: Schizophrenia Research, Bind 257, 2023, s. 27-33.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - The influence of comorbid disease on premature death due to natural and unnatural causes in persons with schizophrenia
AU - Kruckow, Line
AU - Basit, Saima
AU - Nordentoft, Merete
AU - Banner, Jytte
AU - Boyd, Heather Allison
N1 - Publisher Copyright: © 2023 The Authors
PY - 2023
Y1 - 2023
N2 - Background: Comorbid disease may increase mortality in persons with schizophrenia, but how specific diseases are associated with natural and unnatural death in different age groups is unclear. Aims: To investigate the association between eight major comorbid diseases and death from natural and unnatural causes in different age groups in persons with schizophrenia. Method: Retrospective register-based cohort study in 77,794 persons with schizophrenia in Denmark, 1977–2015. Using Cox regression in matched cohorts, we estimated hazard ratios for natural and unnatural death in three age groups (<55 years, 55–64 years, ≥65 years). Results: Hypertensive disease, atrial fibrillation, coronary heart disease, cerebrovascular disease, heart failure, type 2 diabetes, liver disease and chronic kidney disease were all strongly associated with natural death, with the strongest associations observed in persons <55 years (hazard ratio [HR] range 1.98–7.19). The strongest associations were observed for heart failure (HR 7.19, 95 % confidence interval [CI] 5.57–9.28; HR 4.56, CI 3.85–5.40; HR 2.83, CI 2.53–3.17), liver disease (HR 4.66, CI 3.59–6.05; HR 4.70, CI 3.55–6.22; HR 2.57, CI 1.98–3.34) and chronic kidney disease (HR 6.59, CI 1.66–26.1; HR 7.37, CI 3.03–17.9; HR 2.86, CI 1.84–4.46) for persons <55 years, 55–64 years and ≥65 years, respectively. Liver disease was strongly associated with unnatural death in persons <55 years (HR 5.42, CI 3.01–9.75); associations with the remaining comorbidities were weaker. Conclusions: Comorbid disease was strongly associated with natural death, with the strength of the associations decreasing with age. Comorbid disease was also modestly associated with unnatural death, regardless of age.
AB - Background: Comorbid disease may increase mortality in persons with schizophrenia, but how specific diseases are associated with natural and unnatural death in different age groups is unclear. Aims: To investigate the association between eight major comorbid diseases and death from natural and unnatural causes in different age groups in persons with schizophrenia. Method: Retrospective register-based cohort study in 77,794 persons with schizophrenia in Denmark, 1977–2015. Using Cox regression in matched cohorts, we estimated hazard ratios for natural and unnatural death in three age groups (<55 years, 55–64 years, ≥65 years). Results: Hypertensive disease, atrial fibrillation, coronary heart disease, cerebrovascular disease, heart failure, type 2 diabetes, liver disease and chronic kidney disease were all strongly associated with natural death, with the strongest associations observed in persons <55 years (hazard ratio [HR] range 1.98–7.19). The strongest associations were observed for heart failure (HR 7.19, 95 % confidence interval [CI] 5.57–9.28; HR 4.56, CI 3.85–5.40; HR 2.83, CI 2.53–3.17), liver disease (HR 4.66, CI 3.59–6.05; HR 4.70, CI 3.55–6.22; HR 2.57, CI 1.98–3.34) and chronic kidney disease (HR 6.59, CI 1.66–26.1; HR 7.37, CI 3.03–17.9; HR 2.86, CI 1.84–4.46) for persons <55 years, 55–64 years and ≥65 years, respectively. Liver disease was strongly associated with unnatural death in persons <55 years (HR 5.42, CI 3.01–9.75); associations with the remaining comorbidities were weaker. Conclusions: Comorbid disease was strongly associated with natural death, with the strength of the associations decreasing with age. Comorbid disease was also modestly associated with unnatural death, regardless of age.
KW - Comorbidity
KW - Epidemiology
KW - Mortality
KW - Schizophrenia
KW - Somatic
U2 - 10.1016/j.schres.2023.04.006
DO - 10.1016/j.schres.2023.04.006
M3 - Journal article
C2 - 37244167
AN - SCOPUS:85159928029
VL - 257
SP - 27
EP - 33
JO - Schizophrenia Research
JF - Schizophrenia Research
SN - 0920-9964
ER -
ID: 356037079