Pesquisa recente da Fundação Seade analisou as informações dos boletins de ocorrência de 1.622 acidentes de transporte com produtos perigosos, registrados entre 1997 e 1999. Os registros de acidentes envolvendo o transporte rodoviário de produtos perigosos foram localizados no espaço geográfico, em uma base georreferenciada, com a finalidade de se identificar as principais concentrações espaciais desses acidentes.
Esse trabalho não teria sido realizado sem a colaboração dos professores, colegas e amigos entre os quais agradeço de modo especial: Jair Ucio Ferre:;-. Santos que conduziu minha orientação num clima de emizade e diálogo.
Purpose
To estimate the mortality rates of a cohort of Brazilian patients after their first psychiatric admission and determine the possible risk factors associated with excess mortality.
Methods
The study included a cohort of psychiatric patients hospitalised from Jan 1, 2002 to Dec 31, 2007 in the catchment area of Ribeirão Preto, São Paulo state, Brazil. Data were linked to deaths that occurred between Jan 1, 2002 and Dec 31, 2016 from the SEADE Foundation (state data analysis system of São Paulo). The mortality rate (MR), age-sex-standardised mortality ratio (SMR), life expectancy at birth, and years of life lost (YLL) were computed. The factors associated with mortality were analysed by survival analysis using a Cox proportional hazards regression model.
Results
Of 4019 patients admitted (54.76% male), 803 died (69.74% male) during the follow-up (median = 11.25 years). Mortality rates were approximately three-fold higher than expected (SMR = 2.90, 95% CI 2.71–3.11). The highest mortality rate was noted in men with alcohol-related disorders (SMR = 5.50, 95% CI 4.87–6.19). Male sex (adjusted hazard ratio (aHR) = 1.62, 95% CI 1.37–1.92), higher age (aHR = 21.47, 95% CI 13.48–34.17), and unemployment (aHR = 1.22, 95% CI 1.05–1.43) significantly increased the mortality risk from all causes. The average YLL was 27.64 years with the highest YLL noted in nonalcohol substance-related disorders (39.22 years). The life expectancy at birth in this cohort was 47.27 years. Unnatural causes of death were associated with nonwhite skin colour and substance-related disorders.
Conclusion
An excess of mortality and a significant reduction in life expectancy of mentally disordered patients who were first admitted to psychiatric beds was noted, particularly patients admitted for substance-related disorders, which should represent a priority in mental health policies.
Projeções populacionais para o Estado de São Paulo realizadas pela Fundação Seade, a partir dos estudos detalhados sobre os componentes da dinâmica demográfica: fecundidade, mortalidade e migração. A metodologia utilizada considera a interação desses três componentes e a formulação de hipóteses de comportamento futuro.
A Fundação Seade responde pelo Sistema de Estatísticas Vitais de São Paulo, com base na Pesquisa Mensal de Eventos Vitais. Essas informações são produzidas desde o final do século XIX e constituem um rico acervo de dados que permitem o monitoramento das variáveis demográficas e subsidiam as atividades de planejamento.
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