Internal Comparisons: Predictors of Suicide and Accidental Death
Based on Fine-Gray Model
The Fine-Gray model revealed that age was found to be a protective
factor for suicide (HR=0.98; 95% CI [0.97-0.99]; P<0.001)
but an independent risk factor for accidental death (HR=1.02; 95% CI
[1.01-1.03]; P<0.001) among patients with ovarian cancer
(Supplementary Table.2 ). Patients with high-grade ovarian
cancer had a higher risk of suicide rather than accidental death than
those with low-grade ovarian cancer. Besides, patients with localized
(HR=1.85; 95% CI [1.11-3.08]; P=0.019 and HR=2.08; 95% CI
[1.56-2.78]; P<0.001) or regional ovarian cancer (HR=1.97;
95% CI [1.12-3.47]; P=0.019 and HR=1.65; 95% CI [1.19-2.19];
P=0.003) had relatively higher risk of suicide and accidental death
compared with those with distant ovarian cancer. The risk of suicide
among patients who underwent pelvic exenteration (HR=4.14; 95% CI
[1.07-15.98]; P=0.039) for ovarian cancer was approximately five
times that of patients who underwent oophorectomy without hysterectomy,
while there was no statistical difference in the risk of accidental
death in the two groups (HR=1.03; 95% CI [0.40-2.62]; P=0.960).Figure.2 showed the cumulative incidence of suicide and
accidental death among patients who underwent different types of surgery
throughout follow-up. Moreover, patients with localized or regional
ovarian cancer had a significantly high risk of suicide and accidental
death. The high-grade cancer population had a higher rate of suicide
risk while the risk of accidental death was the same as that of the
low-grade cancer population.