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[冰岛国家大学医院综合重症监护病房2000 - 2004年自杀未遂治疗的临床情况及随访]

[Clinical aspects and follow up of suicide attempts treated in a general intensive care unit at Landspitali University Hospital in Iceland 2000-2004].

作者信息

Sverrisson Kristinn Orn, Palsson Sigurdur Páll, Sigvaldason Kristinn, Kárason Sigurbergur

出版信息

Laeknabladid. 2010 Feb;96(2):101-7. doi: 10.17992/lbl.2010.02.11.

DOI:10.17992/lbl.2010.02.11
PMID:20118504
Abstract

OBJECTIVE

To gather information on patients admitted to an intensive care unit (ICU) after a serious suicide attempt (SA).

METHODS

Retrospective analysis and follow up of admittances to ICUs of Landspitali University Hospital after SA years 2000-2004.

RESULTS

Admittances because of SA were 251 (4% of ICU admissions, 61% females, 39% males, mean age 36 yr +/- 14 ). Ten percent were admitted more than once and 61% had prior history of SA. Drug intoxication was the most prevalent type of SA (91%) and the most frequent complication was pneumonia. Following ICU stay 36% of the patients were admitted to psychiatric wards and 80% received psychiatric follow up. The main psychiatric diagnosis was addiction (43%). Majority of patients were divorced or single and the rate of unemployment was high. Mortality during ICU stay was 3%. During 3-7 year follow up 21 patients died (10 %), majority due to suicide. In a survival analysis only the number of tablets taken, APACHE II score and number of somatic diseases predicted risk of death.

CONCLUSION

The patient group is young (36 yr), majority are women (61%), repeated attempts are frequent, social circumstances are poor and death rate after discharge from hospital is high (10%) even though the vast majority (80%) receives psychiatric follow up.This raises the question if the offered treatment is effective enough. Key words: Suicide attempt, suicide, drug poisoning, intensive care, mental health care.

摘要

目的

收集重症监护病房(ICU)收治的严重自杀未遂(SA)患者的信息。

方法

对2000 - 2004年兰斯皮塔利大学医院ICU收治的SA患者进行回顾性分析和随访。

结果

因SA入院的患者有251例(占ICU入院患者的4%,女性占61%,男性占39%,平均年龄36岁±14岁)。10%的患者多次入院,61%有SA病史。药物中毒是最常见的SA类型(91%),最常见的并发症是肺炎。在ICU住院后,36%的患者被转入精神科病房,80%接受了精神科随访。主要精神科诊断为成瘾(43%)。大多数患者离婚或单身,失业率高。ICU住院期间死亡率为3%。在3 - 7年的随访中,21例患者死亡(10%),大多数死于自杀。生存分析显示,仅服用药片的数量、急性生理与慢性健康状况评分系统(APACHE II)评分和躯体疾病数量可预测死亡风险。

结论

该患者群体年轻(36岁),多数为女性(61%),多次自杀未遂频繁,社会状况不佳,出院后死亡率高(10%),尽管绝大多数(80%)接受了精神科随访。这引发了所提供的治疗是否足够有效的问题。关键词:自杀未遂、自杀、药物中毒、重症监护、精神卫生保健

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