BackgroundSuicide is a significant public health problem worldwide. Suicide rates among elderly persons (≥ 65 years of age) are three times higher than those of younger people in Korea. The emergency department is an important entry of drug-related suicide attempt patients. In this study, we compared the frequency of drug types by age subgroup. Furthermore, we provide suggestions for preventing suicide attempts in the elderly.MethodsWe investigated 433 patients who were admitted to the emergency department for drug-related suicide attempts between 1 May 2015 and 30 April 2017.ResultsThe proportion of patients who overdosed on antidepressants was 32.5% in the non-elderly age group and 8.0% in the elderly group (≥ 65 years of age) (P < 0.001). Among the elderly, the most commonly ingested agent was hypnotics (59.1%) (P < 0.001). Compared with the non-elderly, the results showed that the elderly used fewer antidepressants (P < 0.001) and analgesics (P < 0.001). Meanwhile, the elderly used more hypnotics (P < 0.001). Over-the-counter drugs and other medications showed similar usage trends in both age groups (P = 0.664, P = 0.193).ConclusionThe categories of drugs ingested for suicide attempts vary widely between different age groups. Younger people used antidepressants more frequently in suicide attempts, while the elderly used hypnotics more frequently. And the elderly required longer hospital stays. Suicide ideation and depressive mood in older patients who are prescribed hypnotics for various reasons should not be neglected. Further prevention efforts are needed to prevent suicide among the elderly.

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.

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.

Introduction: Transverse myelitis (TM) is a rare inflammatory disorder involving single or multiple spinal segments. There are various Infectious and parainfectious causes. Case presentation: We report the case of 29-year-old female who presented to an emergency department with acute urinary retention, progressive headache and sensory and motor deficits with a genital infection. Cerebrospinal fluid (CSF) analysis revealed WBC 75/μL, protein 96 (15-40 mg/dL), and VZV IgG positive. The magnetic resonance image (MRI) of the spine revealed acute transverse myelitis of C4, C6/C7 and T2-T3, T4-T7. She was treated with steroid pulse therapy, intravenous antiviral therapy, antibiotics, and rehabilitation. Urinary symptoms resolved in six days and her motor deficit resolved. She had mild numbness in the thigh area 2 months later. Discussion: Identification of the causes and diagnosis of TM are challenging because there are variable clinical signs and numerous potential pathogens. Conclusion: It is essential to diagnosis TM in the early and timely phase, careful, detailed history and thorough physical examination by emergency physicians.

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 hospitalization of patients who attempted suicide and aimed to provide criteria for hospitalization decisions for physicians. Methods This study included who had deliberately self-harmed (age ≥19 years) and who 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 who were admitted to the psychiatric wards were excluded. Results This study included 414 patients in the hospitalization 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 hospitalized 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 hospitalized and discharged groups, respectively . In the hospitalized 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 hospitalize 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 hospitalization and reduce ED LOS and crowding.