A Retrospective Cohort Study of the Prevalence of Attempted Suicide by Pesticide Poisoning and Related Factors among Patients Presenting to Chiangrai Prachanukroh Hospital during 2012 - 2021
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Abstract
Objective: To investigate the prevalence of pesticide use in suicide attempts and the factors associated with pesticide use, including gender, age, types of commonly used pesticides, mortality rates, gender and age groups of those who died, the risk of death from different types of pesticides, complications from pesticide use, and the duration from hospital admission to death among patients attempting suicide treated at Chiangrai Prachanukroh Hospital from 2012 to 2021.
Methods: This research is a retrospective cohort study of patients who attempted suicide and attended the emergency room of Chiangrai Prachanukroh Hospital. Data were collected from medical records and hospital databases using ICD-10 codes related to self-harm (X60-X84), including death certificates from the Registrar's Office.
Results: A total of 2,639 patients who attempted suicide were treated in 2,800 hospital visits. Of these, 987 visits (35.2%) involved suicide attempts using pesticides. The average age was 39.1±16.9 years, with a male-to-female ratio of 2.1:1. The most commonly used pesticide was paraquat (65.7%), followed by glyphosate (6.7%) and organophosphates (5.0%). Patients who used paraquat had the highest mortality rate (53.5%), with most deaths occurring within the first four days and 39.7% of deaths occurring after hospital discharge. The main complications were acute respiratory failure, acute liver failure, and acute renal failure. The ban on paraquat in 2020 resulted in a significant decrease in deaths from this pesticide, from 34 in 2020 to 13 in 2021.
Conclusion: The use of pesticides for suicide attempts is prevalent in agricultural communities, particularly with paraquat, which has a high mortality rate. Banning the use of paraquat may be a crucial measure in reducing suicide-related deaths in the agricultural areas of Chiang Rai province.
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