Fossi Larissa Djembi, Debien Christophe, Demarty Anne-Laure, Vaiva Guillaume, Messiah Antoine
INSERM, MOODS Research unit "Depression, Anxiety, Psychotraumatism and Suicide", Centre de recherche en Epidémiologie et santé des populations (CESP), Université Paris-Saclay, Hôpital Paul-Brousse, Villejuif, France.
INSERM, Sorbonne University, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Social Epidemiology Team, Paris, France.
PLoS One. 2022 Mar 1;17(3):e0263379. doi: 10.1371/journal.pone.0263379. eCollection 2022.
Brief Contact Interventions (BCIs) after a suicide attempt (SA) are an important element of prevention against SA and suicide. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls and sending postcards, according to a predefined algorithm. However, a major obstacle to such real-life intervention is the loss of contact during follow-up. Here, we analyze the occurrence of loss of follow-up (LFU) and compare characteristics of patients LFU with follow-up completers.
The study concerned patients included in VigilanS over the period from 1st January 2015 to 31 December 2018, with an end of follow-up on 1st July 2019. We performed a series of descriptive analysis and logistic regressions. The outcome was the loss to follow-up, relative to the 6th month call marking the end of the follow-up; the predictive variables were the characteristics of the patient at entry and during follow-up. Age and sex were considered as adjustment variables.
11879 inclusions occurred during the study period, corresponding to 10666 different patients. The mean age was 40.6 ± 15 years. More than a third were non-first suicide attempters (46.6%) and the most frequent means of suicide was by voluntary drug intoxication (83.2%). 8335 patients were LFU. After simple and multiple regression, a significant relationship with loss to follow-up was identified among non-first suicide attempters, alcohol consumers, patients having no companion on arrival at the emergency room, patients who didn't make or receive any calls. An increased stay in hospital after a SA was a protective factor against loss of follow-up.
A majority of patients were lost to follow-up by the expected surveillance time of 6 months. Characteristics of lost patients will help focusing efforts to improve retention in the VigilanS program and might give insights for BCI implemented elsewhere.
自杀未遂（SA）后的简短接触干预（BCIs）是预防SA和自杀的重要组成部分。VigilanS根据预定义算法，将结合资源卡、电话和明信片的BCI推广到整个法国地区。然而，这种实际干预的一个主要障碍是随访期间的失访。在此，我们分析失访（LFU）的发生率，并比较LFU患者与随访完成者的特征。
该研究涉及2015年1月1日至2018年12月期间纳入VigilanS的患者，随访于2019年7月1日结束。我们进行了一系列描述性分析和逻辑回归。结局是相对于标志随访结束的第6个月电话随访的失访情况；预测变量是患者入组时和随访期间的特征。年龄和性别被视为调整变量。
研究期间有11879例患者纳入，对应10666例不同患者。平均年龄为40.6±15岁。超过三分之一为非首次自杀未遂者（46.6%），最常见的自杀方式是自愿药物中毒（83.2%）。有8335例患者失访。经过单因素和多因素回归分析，发现非首次自杀未遂者、饮酒者、急诊室就诊时无陪伴者、未拨打或接听任何电话的患者与失访存在显著关联。SA后住院时间延长是预防失访的保护因素。
大多数患者在预期的6个月监测期内失访。失访患者的特征将有助于集中精力改善VigilanS项目中的留存率，并可能为其他地方实施的BCI提供见解。
