Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, South Korea.
Department of Nephrology, Chung-Ang University College of Medicine, Seoul, South Korea.
Front Public Health. 2021 Feb 26;9:592770. doi: 10.3389/fpubh.2021.592770. eCollection 2021.
The purpose of this study was to compare the characteristics of suicide attempts by drug overdose between young people and adults, and evaluate the cost-effectiveness of a multi-disciplinary emergency consultation system (MECS) for suicide attempters with drug overdose. It was verified by comparing and analyzing data from June 1, 2017 to May 31, 2018 (before the MECS was implemented; pre-MECS), and from June 1, 2018 to May 31, 2019 (after the MECS was implemented; post-MECS). The data were retrospectively reviewed for a total of 251 such patients with suicide attempts by drug overdose who visited the emergency room of a university hospital in Seoul during the period. The young people group were shown to be more likely to use painkillers and less likely to use psychoactive drugs for a suicide attempt ( < 0.01), had more unplanned attempts than planned ones ( < 0.01), and had lower levels of intentionality for suicide ( = 0.04) and of suicide lethality ( = 0.02), compared to the adult group. We defined suicide attempts as being "serious" when there was both high intentionality and lethality. On this basis, the young people group had less serious suicide attempts, compared to the adult group ( = 0.02). Young people in the post-MECS group had lower intensive care unit (ICU) costs ( = 0.01) and lower costs in the 6-months after the suicide attempt ( = 0.02) compared to those in the pre-MECS group. Young people, both with serious ( < 0.01) and non-serious attempts ( < 0.01) in the post-MECS group had lower ICU costs compared to those in the pre-MECS group. Adults with non-serious attempts in the post-MECS group had lower ICU costs ( < 0.01) compared to those in the pre-MECS group. Therefore, it can be concluded that fast and precise cooperation from the multidisciplinary departments for patients who attempted suicide by drug overdose reduced unnecessary ICU treatment and costs, especially in young attempters and those with lower levels of intentionality and lethality.
这项研究的目的是比较青少年和成年人因药物过量导致的自杀未遂者的特征，并评估多学科急诊咨询系统（MECS）对药物过量自杀未遂者的成本效益。通过比较和分析 2017 年 6 月 1 日至 2018 年 5 月 31 日（MECS 实施前；前 MECS）和 2018 年 6 月 1 日至 2019 年 5 月 31 日（MECS 实施后；后 MECS）的数据来验证。共回顾了首尔某大学医院急诊室期间因药物过量自杀未遂的 251 例患者的数据。与成年组相比，青少年组更有可能使用止痛药且更不可能使用精神活性药物自杀（<0.01），无计划的尝试多于计划的尝试（<0.01），自杀意图（=0.04）和自杀致命性（=0.02）较低。我们将自杀企图定义为高意图和高致命性时为“严重”。在此基础上，青少年组自杀未遂的严重程度低于成年组（=0.02）。与前 MECS 组相比，后 MECS 组青少年的重症监护病房（ICU）费用（=0.01）和自杀未遂后 6 个月的费用（=0.02）较低。后 MECS 组严重（<0.01）和非严重（<0.01）尝试的年轻人 ICU 费用均低于前 MECS 组。后 MECS 组非严重尝试的成年人 ICU 费用（<0.01）低于前 MECS 组。因此，可以得出结论，多学科部门对药物过量自杀未遂者的快速、准确合作减少了不必要的 ICU 治疗和费用，尤其是对意图和致命性较低的青少年和成年人。
