Predicting ICU admissions from attempted suicide presentations at an Emergency Department in Central Queensland

Walker, Xaviour; Lee, Joon; Koval, Lidia; Kirkwood, Alana; Taylor, Jessica Averitt; Gibbs, Justin; Ng, Samantha; Steele, Lynne; Thompson, Peter; Celi, Leo Anthony

doi:10.4066/amj.2013.1730

Cited by 11 publications

(8 citation statements)

References 13 publications

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“…Due to lack of data from the sources, it was a challenge to identify the motivating factors for choosing OD over NOD methods. However, the near significant gender difference in suicide methods observed in our results, mirrored evidence in the literature that women tend to use less violent suicide methods like poisoning [20, 21] as compared to men who tend to use NOD methods such as hanging [22]. …”

Section: Discussionsupporting

confidence: 86%

Profile differences between overdose and non-overdose suicide attempts in a multi-ethnic Asian society

Ong

Tan

et al. 2016

BMC Psychiatry

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BackgroundThis study explores differences in characteristics of overdose (OD) and non-overdose (NOD) suicide attempts in Singapore.MethodsFour hundred eighty-five medical records of people who attempted suicide were extracted from a local general hospital patient database and classified into OD and NOD groups. Differences in socio-demographic factors, suicide characteristics and hospital admission types between both groups were examined.ResultsIndians were more likely than the Chinese and Malays to employ OD method in their attempts. More suicide attempts in the OD group than NOD group were self-reported. The most likely place for suicide attempts for both groups was at home, though more NOD suicide attempts were in public areas as compared to the OD group. Analgesics were the most used substance in the OD group. Those who attempted suicide using OD had a higher number of psychiatric ward admissions than the NOD group. Risk and protective factors varied between both groups.ConclusionDifferences in socio-demographics, suicide characteristics and admission characteristics between OD and NOD groups were observed. Recommendations for suicide prevention in the community are discussed. Further studies on the mediators and moderators of these trends and characteristics of suicide attempts are necessary to ensure maximal efficacy of prevention and management.

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Section: Discussionsupporting

confidence: 86%

Profile differences between overdose and non-overdose suicide attempts in a multi-ethnic Asian society

Ong

Tan

et al. 2016

BMC Psychiatry

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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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“…In this study, drug overdose was the commonest method of suicide (52.4% of the total patients), and had similar rates in the hospitalization and discharge groups. Walker et al had reported drug overdose to be a strong predictor of ICU admission [18] | 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 [19]. This study excluded patients who died while in the ED or within 24 h of hospitalization, and those patients who represented less than 10% of all suicide attempters.…”

Section: Discussionmentioning

confidence: 99%

Indicators of early hospitalization decision to shorten emergency department length of stay of suicide attempters

Kim¹,

Lee²

2020

Preprint

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Background Suicide attempters contribute to a significant public health problem. Individuals are estimated to make up to 20 suicide attempts before committing suicide. The emergency department (ED) is the first location where suicide attempters are brought. This study investigated the factors associated with early hospitalization decisions to determine the criteria for patient hospitalization rather than psychiatric ward admission and identify measures to shorten ED length of stay (LOS). Methods This study included suicide attempters (age ≥19 years) who visited the EDs at two tertiary teaching hospitals between March 2017 and April 2020. Results A total of 414 in the hospitalization and 1,346 in the discharge groups patients were included. The mean age was 50.3 ± 20.0 years and 40.7 ± 17.0 years in the hospitalization and discharge groups (p <0.001). The mean ED LOS was 4.2 ± 12.3 and 11.4 ± 18.8 h in the hospitalization and discharge groups, respectively. In the hospitalization group, the odds ratio and confidence interval for age (1.017, 1.008–1.026), sex (male) (1.787, 1.127–2.515), consciousness (2.330, 1.653–3.266), and the Risk-Rescue Ratio Scale (RRRS) (1.273, 1.242–1.304) were calculated. A receiver operating characteristics analysis of RRRS for the decision to hospitalize suicide attempters showed a cut-off value of 42, with sensitivity, specificity, and area under the curve of 85.7%, 85.5%, and 0.924, respectively.Conclusion For suicidal attempters in the ED, the decision on medical hospitalization rather than psychiatric admission should be based on their level of consciousness and the RRRS to reduce ED LOS and crowding.

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Predicting ICU admissions from attempted suicide presentations at an Emergency Department in Central Queensland

Cited by 11 publications

References 13 publications

Profile differences between overdose and non-overdose suicide attempts in a multi-ethnic Asian society

Profile differences between overdose and non-overdose suicide attempts in a multi-ethnic Asian society

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

Indicators of early hospitalization decision to shorten emergency department length of stay of suicide attempters

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