Suicide reattempts and suicide deaths in patients attending the emergency room of Chiang Rai Prachanukroh Hospital with self-harm problems: A survival analysis
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Abstract
Objectives: To investigate the risk of reattempt suicidal behavior and related factors in patients admitted to the emergency room with a suicidal attempt.
Methods: This was a retrospective cohort study by collecting information in patients' medical records of patients who came to the emergency room of Chiang Rai Prachanukroh Hospital with self-harm problems from January 1, 2012 to December 31, 2018. The Kaplan-Meier (KM) method was used to analyze 'time-to-event' data. Cox-proportional hazard regression was applied to calculate the hazard ratios for the predictors of suicide.
Results: There were 1,409 patients in the study. 738 (52.4%) of them were female with a mean age of 31.9 years (SD = 14.9). 68 (4.8%) patients had reattempt suicide and 40 (2.8%) died from suicide. The risks of suicide reattempt (39.7%) and suicide death (50%) were highest during the first year. Patients with a history of suicide attempts (p = 0.03), and a history of psychiatric disease (p < 0.01) were at high risk for reattempt suicide. The high lethality method was found to have a lower risk of reattempt suicide than the low lethality method (p = 0.02). The risk of subsequent death by suicide was high in males (p = 0.03), patients with a history of suicide attempts (p <0.01) and patients with a history of psychiatric disorders (p<0.01).
Conclusion: The risks of reattempt suicide and suicide death are highest during the first 6 - 12 months after an index suicide attempt indicating the critical period. It is crucial for health care workers to be aware of the risks and provide prompt and appropriate interventions, particularly in patients with a history of suicide attempts or psychiatric disorders.
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