Physiological characteristics of patients with schizophrenia prematurely dying from circulatory diseases

Introduction: Patients with schizophrenia before reaching geriatric age are at high risk of circulatory mortality. However, investigations are lacking on the characteristics of physiological measurement among these at-risk patients. Methods: In this study, we followed acutely inpatients with schizophrenia disorder for cause of death through record linkage to the Death Certification System in Taiwan. Cases of patients who died because of circulatory morbidity (ICD–9 401–443) before turning 65 years old were used. Each schizophrenia case was then matched with two mentally healthy controls for the age and sex, and date of laboratory examination. Clinical data of all subjects were obtained by reviewing medical records. Results: Totally, 81 patients with schizophrenia who died from circulatory diseases at mean ages of 48.0 ± 10.7 years were investigated. The mean age at the final acute psychiatric hospitalization was 43.0 ± 10.9 years. Multivariate analysis showed that elevated fasting serum glucose levels (95% confidence interval [CI] for odds ratio (OR) = 1.00–1.03), blood leukocyte counts (95% CI for odds ratio (OR) = 1.07–1.55), and heart rates on electrocardiogram (95% CI for OR = 1.04–1.10) in the final psychiatric hospitalization collectively provided the predictive validity for premature circulatory death. Conclusion: Systemic inflammatory activation and autonomic nervous system dysfunction along with dysregulation of glucose metabolism rather than lipids could be the physiological characteristics of schizophrenia patients at risk of premature circulatory mortality.