Goldman-Mellor Sidra, Olfson Mark, Schoenbaum Michael
Department of Public Health, University of California, Merced, California, USA
Departments of Psychiatry and Epidemiology, Columbia University Irving Medical Center, New York, NY, USA.
Inj Prev. 2024 Jul 15. doi: 10.1136/ip-2024-045249.
Emergency department patients presenting with non-fatal suicidal behaviour face elevated risk of suicide and all-cause mortality, but the extent to which this has changed over time is unknown. This study tracked trends in mortality risks faced by emergency department patients presenting with deliberate self-harm and suicidal ideation in California.
Using statewide linked emergency department and death data, we estimated 2010-2016 trends in suicide and all-cause mortality among emergency department patients with either deliberate self-harm (n=111 658) or suicidal ideation (n=162 959). We also calculated average annual percent changes in age-adjusted mortality rates and compared these to the general California population.
Deliberate self-harm and suicidal ideation patients' age-adjusted suicide rates decreased by approximately 5% per year during the study period; however, their all-cause mortality trends were flat. In the general California population, suicide rate trends were flat while all-cause mortality slightly declined.
Suicide mortality unexpectedly declined among self-harming and suicidal patients presenting to California emergency departments. Additional research is needed to understand the reasons behind this decline and inform quality improvement efforts for suicide prevention in hospital settings.
因非致命性自杀行为就诊于急诊科的患者面临着更高的自杀风险和全因死亡率，但随着时间推移这种情况的变化程度尚不清楚。本研究追踪了加利福尼亚州因故意自伤和自杀意念就诊于急诊科的患者所面临的死亡风险趋势。
利用全州范围内急诊科与死亡数据的关联，我们估算了2010 - 2016年期间因故意自伤（n = 111658）或自杀意念（n = 162959）就诊于急诊科的患者的自杀和全因死亡率趋势。我们还计算了年龄调整死亡率的年均变化百分比，并将其与加利福尼亚州普通人群进行比较。
在研究期间，故意自伤和有自杀意念患者的年龄调整自杀率每年下降约5%；然而，他们的全因死亡率趋势平稳。在加利福尼亚州普通人群中，自杀率趋势平稳，而全因死亡率略有下降。
在就诊于加利福尼亚州急诊科的自伤和有自杀意念患者中，自杀死亡率意外下降。需要进一步研究以了解这种下降背后的原因，并为医院环境中的自杀预防质量改进工作提供信息。
