Rogers Steven C, Sacco Shane J, Volz Kristen, Chenard Danielle, Borrup Kevin, Chen Kun, Aseltine Robert H
Center for Population Health, UConn Health, Farmington, Connecticut, United States of America.
Connecticut Children's Medical Center, Hartford, Connecticut, United States of America.
PLoS One. 2025 Jun 23;20(6):e0321934. doi: 10.1371/journal.pone.0321934. eCollection 2025.
Suicide is a leading cause of death in the United States. In 2018, the Joint Commission recommended screening patients for suicide risk in healthcare settings. Universal screening may increase the safety of at-risk youth, but is challenging for many pediatric emergency departments. We examined the feasibility and outcomes associated with universal suicide risk screening using a combination of two screening tools in a pediatric emergency department. This retrospective cohort study examined 10-18 year old patients presenting to a large, urban pediatric emergency department between September 2019 and August 2021. Key variables included patient demographic information, suicide risk screening results, and subsequent suicide attempts. There were 30,328 encounters in the pediatric emergency department over this two-year period. Screening was completed 84.8% of the time. Of the 17,332 unique patients screened, 83.9% were at minimal suicide risk, 7.0% low risk, 2.1% moderate risk, and 7.0% high risk. In the 6 months following screening, low-risk patients returning to the emergency department were 7.1 times likely to have a suicide attempt than minimal-risk patients, moderate-risk patients were 9.8 times likely, and high-risk patients were 15.5 times likely. Universal screening in a pediatric emergency department is feasible and informative. The combined screening tool protocol appeared to enhance efficiency while maintaining clinical accuracy. Universal screening identified a substantial proportion of pediatric emergency department patients at risk of subsequent suicide attempts, with the likelihood of a subsequent attempt strongly linked to increasing risk levels identified by screening.
自杀是美国主要的死亡原因之一。2018年，联合委员会建议在医疗机构对患者进行自杀风险筛查。普遍筛查可能会提高高危青少年的安全性，但对许多儿科急诊科来说具有挑战性。我们在一家儿科急诊科使用两种筛查工具组合，研究了普遍自杀风险筛查的可行性及相关结果。这项回顾性队列研究考察了2019年9月至2021年8月期间前往一家大型城市儿科急诊科就诊的10至18岁患者。关键变量包括患者人口统计学信息、自杀风险筛查结果以及随后的自杀未遂情况。在这两年期间，儿科急诊科共接诊30328人次。筛查完成率为84.8%。在接受筛查的17332名不同患者中，83.9%为最低自杀风险，7.0%为低风险，2.1%为中度风险，7.0%为高风险。在筛查后的6个月内，返回急诊科的低风险患者自杀未遂的可能性是最低风险患者的7.1倍，中度风险患者是9.8倍，高风险患者是15.5倍。在儿科急诊科进行普遍筛查是可行且能提供信息的。联合筛查工具方案似乎提高了效率，同时保持了临床准确性。普遍筛查识别出相当比例的儿科急诊科患者有随后自杀未遂的风险，随后自杀未遂的可能性与筛查确定的风险水平增加密切相关。
