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Predictive factors for the medical hospitalisation of patients who visited the emergency department with suicide attempt.
BMC Psychiatry. 2021 02 06; 21(1):79.BP

Abstract

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.

Authors+Show Affiliations

Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.Department of Emergency Medicine, Ewha Womans University, Anyangchoenro 1071 Yangcheon-gu, Seoul, Republic of Korea. ewhain78@gmail.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33549077

Citation

Kim, Hye Jin, and Duk Hee Lee. "Predictive Factors for the Medical Hospitalisation of Patients Who Visited the Emergency Department With Suicide Attempt." BMC Psychiatry, vol. 21, no. 1, 2021, p. 79.
Kim HJ, Lee DH. Predictive factors for the medical hospitalisation of patients who visited the emergency department with suicide attempt. BMC Psychiatry. 2021;21(1):79.
Kim, H. J., & Lee, D. H. (2021). Predictive factors for the medical hospitalisation of patients who visited the emergency department with suicide attempt. BMC Psychiatry, 21(1), 79. https://doi.org/10.1186/s12888-021-03089-2
Kim HJ, Lee DH. Predictive Factors for the Medical Hospitalisation of Patients Who Visited the Emergency Department With Suicide Attempt. BMC Psychiatry. 2021 02 6;21(1):79. PubMed PMID: 33549077.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictive factors for the medical hospitalisation of patients who visited the emergency department with suicide attempt. AU - Kim,Hye Jin, AU - Lee,Duk Hee, Y1 - 2021/02/06/ PY - 2020/08/09/received PY - 2021/02/02/accepted PY - 2021/2/7/entrez PY - 2021/2/8/pubmed PY - 2021/4/27/medline KW - Emergency department KW - Hospitalisation KW - Length of stay KW - Suicide attempt SP - 79 EP - 79 JF - BMC psychiatry JO - BMC Psychiatry VL - 21 IS - 1 N2 - 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. SN - 1471-244X UR - https://www.unboundmedicine.com/medline/citation/33549077/Predictive_factors_for_the_medical_hospitalisation_of_patients_who_visited_the_emergency_department_with_suicide_attempt_ L2 - https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03089-2 DB - PRIME DP - Unbound Medicine ER -