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Mortality after electroconvulsive therapy
The British Journal of Psychiatry ( IF 8.7 ) Pub Date : 2021-06-24 , DOI: 10.1192/bjp.2021.63
Bradley V Watts 1 , Talya Peltzman 2 , Brian Shiner 3
Affiliation  

Background

There are limited studies examining mortality associated with electroconvulsive therapy (ECT), and many studies do not include a control group or method to identify all patient deaths.

Aims

We aimed to evaluate the risk of death associated with ECT treatments over 30 days and 1 year.

Method

We conducted a study analysing electronic medical record data from the Department of Veterans Affairs healthcare system between 2000 and 2017. We compared mortality among patients who received ECT with a matched group of patients created through propensity score matching.

Results

Our sample included 123 479 individual ECT treatments provided to 8720 patients (including 5157 initial index courses of ECT). Mortality associated with individual ECT treatments was 3.08 per 10 000 treatments over the first 7 days after treatment. When comparing patients who received ECT with a matched group of mental health patients, those receiving ECT had a relative odds of all-cause mortality in the year after their index course of 0.87 (95% CI 0.79–1.11; P = 0.10), and a relative risk of death from causes other than suicide of 0.79 (95% CI 0.66–0.95; P < 0.01). The similar relative odds of all-cause mortality in the first 30 days after ECT was 1.06 (95% CI 0.65–1.73) for all-cause mortality, and 1.02 (95% CI 0.58–1.8) for all-cause mortality excluding suicide deaths.

Conclusions

There was no evidence of elevated or excess mortality after ECT. There was some indication that mortality may be reduced in patients receiving ECT compared with similar patients who do not receive ECT.



中文翻译:

电休克治疗后的死亡率

背景

检查与电休克疗法 (ECT) 相关的死亡率的研究有限,许多研究不包括对照组或确定所有患者死亡的方法。

目标

我们旨在评估 30 天和 1 年内与 ECT 治疗相关的死亡风险。

方法

我们进行了一项研究,分析了 2000 年至 2017 年间退伍军人事务部医疗保健系统的电子病历数据。我们比较了接受 ECT 的患者与通过倾向评分匹配创建的匹配组患者的死亡率。

结果

我们的样本包括为 8720 名患者提供的 123479 次单独的 ECT 治疗(包括 5157 个 ECT 的初始指数课程)。在治疗后的前 7 天内,与个别 ECT 治疗相关的死亡率为 3.08/10 000 次治疗。在将接受 ECT 的患者与匹配的心理健康患者组进行比较时,接受 ECT 的患者在指数疗程后一年的全因死亡率相对几率为 0.87(95% CI 0.79-1.11;P = 0.10),并且死于自杀以外原因的相对风险为 0.79(95% CI 0.66-0.95;P < 0.01)。ECT 后前 30 天内,全因死亡率的相似相对几率为 1.06(95% CI 0.65-1.73),不包括自杀死亡的全因死亡率为 1.02(95% CI 0.58-1.8) .

结论

没有证据表明 ECT 后死亡率升高或过高。有一些迹象表明,与未接受 ECT 的类似患者相比,接受 ECT 的患者的死亡率可能会降低。

更新日期:2021-06-24
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