Cardiovascular Disease in Patients with Schizophrenia in Taiwan: A Population-Based National Health Insurance Study

• Main Authors: Bao-Chiien Chang, 張保欽
• Other Authors: Chun-Hung Hsu
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/bxux2h

碩士 === 元培科技大學 === 醫務管理研究所 === 102 === Objective:Many studies had shown that the risks increase in the morbidity and mortality of cardiovascular disease from schizophrenia patients. The mechanism is still not clear. We researched the risks of cardiovascular disease (CVD) developed and the duration onset in schizophrenia, and suggested the healthcare providers to prevent the morbidity of CVD. Methods:This was a retrospective cohort study from 1996-2007 in Taiwan. We selected the study group (ICD-9-CM code 295, exclude 295.70) from the Psychiatric Disease databases (1998-2007), and the comparison group from the Health Insurance Research Databases (1998-2007), with individual gender- and age-matched by 1:5 ratio. We analyzed the duration of newly CVD developed from the newly diagnosed schizophrenia during 2000 by follow-up at most 8 years. We used SPSS 20th ed. software to analyze the adjusted hazard ratios of CVD and total survival in the 2 groups. Total samples between 20 and 80 years old were 22,434 (3,739 in study and 18,695 in comparison group), and totally 3,734 developed CVD. There were 815 (21.80%) in study group and 2,919 (15.61%) in comparison group. Results:The Adjusted hazard ratio of any CVD developed in the study group was 1.41-fold compared with the comparison group (95% confidence interval [CI]=1.30-1.53, p<0.001). Stroke (or CVA) was the most significant disease of the CVD in the study group, which was 2.16-fold than the comparison group (Adj. HR=2.16; 95% CI=1.83-2.55, p<0.001). Subtypes of CVDs also showed significant findings in the study group: 1.26-fold (95% CI=1.12-1.42, p<0.001), 1.42-fold (95% CI=1.26-1.60, p<0.001), 1.68-fold (95% CI=1.32-2.14, p<0.001) in ischemic heart disease, arrhythmia, and heart failure, respectively. Other subtypes of CVDs (acute myocardial infarct, aortic aneurysm, transient ischemic accident) showed no statistical significance. The total survival after schizophrenia initially diagnosed was average 94.360.17 months in the study group, but was average 95.900.01 months in the comparison group. The former was about 1.44 months shorter than the later one (p<0.001). Conclusion and suggestion: Schizophrenia patients had higher risks and shorter duration to get CVDs and also shorter life expectancy after diagnosis during the 8-years follow-up. It is crucial to closely monitor the risk factors of CVDs, especially in stroke, ischemic heart disease and arrhythmia for younger (20-39 years old) schizophrenia patients.