Risk Factors for Serious Suicide Attempts with High Medical Severity

Kim, Sunghwan; Choi, Kyoung Ho; Lee, Kang‐Sook; Kim, Daijin; Hong, Seung‐Chul; Lee, Hae‐Kook; Kweon, Yong‐Sil; Lee, Chung Tai; Lee, Kyoung‐Uk

doi:10.1111/sltb.12597

Cited by 17 publications

(26 citation statements)

References 72 publications

(90 reference statements)

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“…It is important to measure the lethality of the suicide attempt and prevent serious suicide attempts (SSA), defined as suicide attempt leading to a fatal outcome including death or hospitalization (4,5) because the SSA cause both individual and social burden (4,6). Many factors are involved in SSA or suicide lethality, including medical severity (7,8), previous attempts (9), suicidal intent and method (7,10), male sex (10), previous history and severity of psychiatric diseases (11)(12)(13), alcohol use (14), and age (15). A more comprehensive evaluation of SSA may include contextual information based on methods and circumstances of the suicide attempt because the lethality of the suicide attempt is associated with multiple variables.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department

et al. 2021

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Objective: Suicide attempts of the older adults are known to be more serious than that of the younger adults. Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters in the emergency department.Methods: Demographic data, clinical information, and the level of seriousness of suicide with Risk Rescue Rating Scale were compared between older (age ≥65) and younger (age <65) adults who visited the emergency department for a suicide attempt. Regression analyses were performed to identify the risk factors for SSA in these two groups.Results: Among 370 patients, 37 were older adults (10%; aged 74.41 ± 6.78), more likely to have another medical disease (p < 0.001), and a higher suicide completion rate (16.2 vs. 5.4%, p = 0.023). In the younger group, old age (B = 0.090, p < 0.001), male sex (B = −0.038, p = 0.019), and impression of schizophrenia (B = 0.074, p = 0.027) were associated with a higher risk-rescue ratio and interpersonal stress condition was associated with a lower risk-rescue ratio (B = −0.045, p = 0.006). In the older group, however, no variables were included significant in the regression model for the Risk Rescue Rating Scale.Conclusions: Demographic and clinical factors such as old age, male sex, interpersonal stress, and impression of schizophrenia were associated with lethality in the younger suicide attempters. However, no factors were associated with SSA in the older adult group. Different mechanisms may underly the lethality in old age suicide.

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Section: Introductionmentioning

confidence: 99%

Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department

et al. 2021

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“…In this study, drug overdose was the most common method of suicide (52.4% of the total patients), and had similar rates in both the hospitalised and discharged groups. Walker et al had reported drug overdose to be a strong predictor of ICU admission [25] while Kim et al classified stabbing, hanging, drowning, and jumping off a height as clinically serious, lethal methods, and severe depression, psychological disturbance, and repetitive suicidal ideation as factors that indicated high medical severity [26]. This study excluded patients who died while in the ED or within 24 h of hospitalisation.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors for the medical hospitalisation of patients who visited the emergency department with suicide attempt

Kim

Lee

2021

BMC Psychiatry

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Background Suicide is a significant public health problem. Individuals are estimated to make up to 20 suicide attempts before suicide. The emergency department (ED) is the first location where individuals are brought after a suicide attempt. This study investigated the factors related to delays in the medical hospitalisation of patients who attempted suicide and aimed to provide criteria for hospitalisation decisions by physicians. Methods This study included patients who had deliberately self-harmed (age ≥ 19 years) and presented at the EDs of two tertiary teaching hospitals between March 2017 and April 2020. Those for whom relevant demographic and clinical information were unavailable and those admitted to the psychiatric wards were excluded. Results This study included 414 patients in the hospitalisation group and 1346 in the discharged group. The mean patient age was 50.3 ± 20.0 years and 40.7 ± 17.0 years in the hospitalised and discharged groups (p < 0.001), respectively. The mean ED length of stay (LOS) was 4.2 ± 12.3 and 11.4 ± 18.8 h in the hospitalised and discharged groups, respectively. In the hospitalised group, the odds ratio and confidence interval for aged 35 ~ 64 (2.222, 1.343–3.678), aged over 65 (2.788, 1.416–5.492), sex -male (2.041, 1.302–3.119), and consciousness (1.840, 1.253–2.466). The Risk-Rescue Ratio Scale (RRRS) was (1.298, 1.255–1.343). A receiver operating characteristics analysis of RRRS for the decision to hospitalise patients who attempted suicide showed a cut-off value of 42, with sensitivity, specificity, and area under the curve being 85.7, 85.5%, and 0.924, respectively. Conclusion The level of consciousness and the RRRS of patients who attempted suicide can be the factors to decide medical hospitalisation and reduce ED LOS and crowding.

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“…In this study, drug overdose was the most common method of suicide (52.4% of the total patients), and had similar rates in both the hospitalised and discharged groups. Walker et al had reported drug overdose to be a strong predictor of ICU admission [25] while Kim et al classi ed stabbing, hanging, drowning, and jumping off a height as clinically serious, lethal methods, and severe depression, psychological disturbance, and repetitive suicidal ideation as factors that indicated high medical severity [26]. This study excluded patients who died while in the ED or within 24 h of hospitalisation.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors for the medical hospitalisation of patients who visited the emergency department with suicide attempt

Kim

Lee²

2021

Preprint

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Background Suicide is a significant public health problem. Individuals are estimated to make up to 20 suicide attempts before suicide. The emergency department (ED) is the first location where individuals are brought after a suicide attempt. This study investigated the factors related to delays in the medical hospitalisation of patients who attempted suicide and aimed to provide criteria for hospitalisation decisions by physicians. Methods This study included patients who had deliberately self-harmed (age ≥19 years) and presented at the EDs of two tertiary teaching hospitals between March 2017 and April 2020. Those for whom relevant demographic and clinical information were unavailable and those admitted to the psychiatric wards were excluded. Results This study included 414 patients in the hospitalisation group and 1,346 in the discharged group. The mean patient age was 50.3 ± 20.0 years and 40.7 ± 17.0 years in the hospitalised and discharged groups (p <0.001), respectively. The mean ED length of stay (LOS) was 4.2 ± 12.3 and 11.4 ± 18.8 h in the hospitalised and discharged groups, respectively. In the hospitalised group, the odds ratio and confidence interval for aged 35~64 (2.222, 1.343–3.678), aged over 65 (2.788, 1.416-5.492), sex -male (2.041, 1.302–3.119), and consciousness (1.840, 1.253–2.466). The Risk-Rescue Ratio Scale (RRRS) was (1.298, 1.255–1.343). A receiver operating characteristics analysis of RRRS for the decision to hospitalise patients who attempted suicide showed a cut-off value of 42, with sensitivity, specificity, and area under the curve being 85.7%, 85.5%, and 0.924, respectively.Conclusion The level of consciousness and the RRRS of patients who attempted suicide can be the factors to decide medical hospitalisation and reduce ED LOS and crowding.

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Risk Factors for Serious Suicide Attempts with High Medical Severity

Cited by 17 publications

References 72 publications

Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department

Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department

Predictive factors for the medical hospitalisation of patients who visited the emergency department with suicide attempt

Predictive factors for the medical hospitalisation of patients who visited the emergency department with suicide attempt

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