Risk of suicide among stroke survivors in the United States

Ben Grobman; Neeharika Kothapalli; Arian Mansur; Christine Y Lu

doi:10.1016/j.jstrokecerebrovasdis.2023.107272

Risk of suicide among stroke survivors in the United States

J Stroke Cerebrovasc Dis. 2023 Oct;32(10):107272. doi: 10.1016/j.jstrokecerebrovasdis.2023.107272. Epub 2023 Aug 19.

Authors

Ben Grobman¹, Neeharika Kothapalli², Arian Mansur³, Christine Y Lu⁴

Affiliations

¹ Harvard Medical School, Boston, Massachusetts, USA. Electronic address: bgrobman@hms.harvard.edu.
² Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
³ Harvard Medical School, Boston, Massachusetts, USA.
⁴ Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA; Kolling Institute, Faculty of Medicine and Health, The University of Sydney and the Northern Sydney Local Health District, Sydney, NSW, Australia; School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

PMID: 37604081
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107272

Abstract

Background: Stroke is the largest cause of disability and the 5^th leading cause of death in the United States. Suicide is the 12^th leading cause of death in the United States. However, little is known about the risk of suicide among people with a prior stroke.

Objectives: Using Multiple Cause of Death data (1999-2020) from the Centers for Disease Control and Prevention WONDER database, we examined via cross-sectional analysis the risk of suicide among survivors of stroke as compared to the general U.S. population and among subgroups within the United States.

Methods: We assessed disparities in suicide rate among patients with stroke stratified by sex, race, urbanization levels, and census regions using the CDC WONDER multiple cause of death database. Standardized mortality rates were calculated to compare the suicide rate of stroke patients with the rates among demographic-matched cohorts and the general United States population.

Results: As compared to the general population, stroke survivors had an elevated risk of suicide. Black stroke survivors had a lower rate of suicide as compared to the general population, while White stroke survivors and those in nonmetropolitan areas had an elevated risk compared to the general population.

Conclusion: There was a slightly elevated risk of suicide among people with a prior stroke in the United States. This risk may be elevated among White people and among people living in nonmetropolitan areas.

Keywords: Database; Observational study; Stroke; Suicide.

MeSH terms

Cross-Sectional Studies
Humans
Rural Population
Stroke* / diagnosis
Suicide*
Survivors
United States / epidemiology