Mortality Rate and Causes of Death in a Canadian Tertiary Schizophrenia Program
Bibliographic record
Abstract
Keywords schizophrenia, mortality, life expectancy, retrospective, chart review People with schizophrenia have an increased mortality rate 1 and decreased life expectancy 2 relative to the general population.Mortality is elevated across a range of causes, including medical illness, suicide, and accidents.1,2 Despite an urgent need to understand mortality trends in order to design protective interventions, the mortality rate and causes of death of people with schizophrenia spectrum disorders (SSDs) have not been studied within the context of a Canadian tertiary mental healthcare centre.We conducted a retrospective chart review of patients (≥18 years) diagnosed with an SSD (schizophrenia, schizoaffective disorder, or psychosis not otherwise specified [NOS]) who died during their enrollment with The Royal Ottawa Mental Health Centre's (ROMHC) Inpatient or Outpatient Schizophrenia Program from June 1, 2014, to July 20, 2022.Outpatients died as outpatients, regardless of admission history.Inpatients died during admission.Death was determined if it occurred during the study period and was documented in the ROMHC's incident reporting system.Patients were not followed after discharge to ascertain mortality.Those with medical or psychiatric comorbidities were eligible for inclusion.Patients were excluded from chart review if they had been admitted to a ROMHC Schizophrenia Program without an SSD diagnosis.Data were extracted from admission, progress, consult, nursing, and social work notes, stored forms or applications, and discharge summaries.Causes of death were obtained from medical records or incident reports.Mortality rate was calculated for all patients enrolled in the ROMHC schizophrenia program at any point during the study period, regardless of chart access, completeness, or diagnosis.This study was approved by the ROMHC Research Ethics Board; informed consent was not required.A total of 109 of the 3035 ROMHC schizophrenia program patients died during the 8-year, 49-day study period, an overall mortality rate of 3.59% (5 inpatient deaths [total inpatients: n = 563], inpatient mortality rate = 0.89%;
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.006 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".