自杀风险评估筛查在小儿骨科门诊中的作用

The Role of Suicide Risk Assessment Screening in the Pediatric Orthopaedic Clinic.

作者信息

Matthews Cortney, Gray Trayce, Tanyi Jordan, McMahon Niamh, Gottschalk Hilton

机构信息

The Dell Medical School at the University of Texas at Austin, Austin, TX, USA.

The University of Houston Tilman J Fertitta Family College of Medicine, Houston, TX, USA.

出版信息

J Pediatr Soc North Am. 2025 Mar 18;11:100177. doi: 10.1016/j.jposna.2025.100177. eCollection 2025 May.

DOI:10.1016/j.jposna.2025.100177

PMID:40432874

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12088332/

Abstract

BACKGROUND

Suicide is the second leading cause of death for youth 12-18 years of age. Identification of adolescents with suicidal ideation can help facilitate early interventions. This study evaluates the use of a PSS-3 Suicide Risk Screener (SRA), given to patients presenting to a specialty pediatric orthopaedic clinic (SCC), to identify suicide risk and interventions performed for these patients.

METHODS

We conducted a retrospective cohort study of the 1920 patients that presented to the SCC in 2022. Every patient that entered the clinic was given a SRA to complete. We determined the frequency of positive screens, negative screens, and incomplete screens and the demographics of the patients in the positive group. We also determined the frequencies of the interventions performed for patients that did have a positive screen.

RESULTS

Of the 1920 patients that presented in the SCC in 2022, 319 patients had an incomplete screen and were excluded from the analysis. One patient was incorrectly coded to have a positive screen in the SCC clinic and was excluded. Of the 1600 patients that had a complete screen, 3% (48) had a positive SRA screen. Of the patients with a positive screen, the mean age was 13.6 years (1.27), 54.2% (26) female, and 89.8% (43) had public insurance. Of note, 23% (11) of those with a positive screen met with a social worker and were admitted to an inpatient facility.

CONCLUSIONS

The addition of the PSS-3 Suicide Risk Screener in this pediatric orthopaedic clinic screened 83% of patients presenting to the clinic and found a 3% positivity rate for patients that completed the screen. In 2022, 1 in every 180 patients who visited the SCC were admitted to an inpatient facility for suicidality. The implementation of a suicide risk assessment helped us to identify a need for intervention in patients originally presenting for musculoskeletal complaints. There is a role for suicide risk screening in pediatric orthopaedic clinics.

KEY CONCEPTS

(1)Utility of suicide screening questionnaires in orthopaedic clinics is poorly understood.(2)This study sought to investigate the risk of suicidality in pediatric orthopaedic patients.(3)Suicide risk screening in pediatric populations can identify patients at risk.(4)Early intervention to address suicide risk in pediatric orthopaedic patients can significantly improve outcome.(5)Suicide risk screening in pediatric orthopaedic clinics has a strong role in better promoting overall health.

LEVEL OF EVIDENCE

Level III.

摘要

背景

自杀是12至18岁青少年的第二大死因。识别有自杀意念的青少年有助于促进早期干预。本研究评估了向专科儿科骨科诊所（SCC）就诊的患者发放PSS - 3自杀风险筛查量表（SRA）以识别自杀风险及对这些患者采取的干预措施。

方法

我们对2022年在SCC就诊的1920例患者进行了一项回顾性队列研究。每位进入诊所的患者都被给予一份SRA量表填写。我们确定了筛查结果为阳性、阴性和不完整的频率，以及阳性组患者的人口统计学特征。我们还确定了对筛查结果为阳性的患者所采取干预措施的频率。

结果

在2022年到SCC就诊的1920例患者中，319例患者的筛查结果不完整，被排除在分析之外。1例患者在SCC诊所被错误编码为筛查结果阳性，也被排除。在1600例筛查结果完整的患者中，3%（48例）的SRA筛查结果为阳性。在筛查结果为阳性的患者中，平均年龄为13.6岁（标准差1.27），54.2%（26例）为女性，89.8%（43例）有公共保险。值得注意的是，筛查结果为阳性的患者中有23%（11例）与社会工作者会面并被收治入院。

结论

在这家儿科骨科诊所增加PSS - 3自杀风险筛查量表后，对83%的就诊患者进行了筛查，完成筛查的患者阳性率为3%。2022年，每180名到SCC就诊的患者中有1人因自杀倾向被收治入院。实施自杀风险评估有助于我们识别最初因肌肉骨骼问题就诊的患者中需要干预的情况。自杀风险筛查在儿科骨科诊所中具有重要作用。