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İntihar girişimi sonrasında yoğun bakım ünitesine yatırılan hastaların demografik, psikiyatrik ve klinik özelliklerinin retrospektif değerlendirilmesi

Year 2025, Volume: 8 Issue: 6, 1133 - 1142, 25.10.2025
https://doi.org/10.32322/jhsm.1752924

Abstract

Amaç: Bu çalışma, intihar girişimi sonrasında yoğun bakım ünitesine yatırılan hastalarda demografik, klinik ve psikiyatrik özellikler ile mortalite arasındaki ilişkiyi değerlendirmeyi amaçlamaktadır.

Yöntem: Ocak 2020 ile Mayıs 2025 tarihleri arasında, Türkiye'nin bir ilindeki üç hastanede intihar girişimi sonrasında yoğun bakım ünitesine yatırılan toplam 121 hasta retrospektif olarak incelendi. Hastaların demografik, klinik ve psikiyatrik verileri tıbbi kayıtlardan elde edilerek mortalite ile ilişkileri değerlendirilmek üzere analiz edildi.

Bulgular: İleri yaş, erkek cinsiyet (ölümle sonuçlanan olguların %96,3’ü erkekti), eşlik eden fiziksel hastalıkların varlığı, yüksek letaliteli intihar yöntemlerinin kullanımı ve yoğun bakım sürecinde psikiyatrik konsültasyon yapılmaması mortalite ile anlamlı şekilde ilişkili bulundu. Özellikle ası, yüksekten atlama ve kesici/delici alet kullanımı gibi yöntemler ölüm riskini belirgin biçimde artırmaktaydı. Bu yöntemleri kullanan hastaların yoğun bakımda kalış süreleri daha uzun olup, kapalı psikiyatri servislerine yönlendirilme oranları da daha yüksekti. Psikiyatrik konsültasyon almayan hastalarda mortalite oranları anlamlı düzeyde daha yüksek saptandı.

Sonuç: Bu retrospektif çalışma, intihar girişimi sonrasında yoğun bakım ünitesine yatırılan hastalarda mortalite ile ilişkili temel risk faktörlerini ortaya koymuştur. İleri yaş, erkek cinsiyet, fiziksel hastalıkların varlığı, yüksek letaliteli intihar yöntemlerinin kullanımı ve psikiyatrik konsültasyonun yapılmaması, bu hasta grubunda mortalitenin başlıca belirleyicileri olarak saptanmıştır. Bulgular, yüksek riskli bireylerin erken tanılanmasının, zamanında psikiyatrik değerlendirme yapılmasının ve müdahalede multidisipliner bir yaklaşım benimsenmesinin intihara bağlı mortalitenin azaltılmasında kritik önem taşıdığını vurgulamaktadır.

References

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  • Gilgoff JN, Wagner F, Frey JJ, Osteen PJ. Help-seeking and man therapy: the impact of an online suicide intervention. Suicid Life Threat Behav. 2023;53(1):154-162. doi:10.1111/sltb.12929
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Retrospective evaluation of the demographic, psychiatric, and clinical characteristics of patients admitted to the intensive care unit following a suicide attempt

Year 2025, Volume: 8 Issue: 6, 1133 - 1142, 25.10.2025
https://doi.org/10.32322/jhsm.1752924

Abstract

Aims: This retrospective, multicenter study aims to evaluate the relationship between demographic, clinical, and psychiatric characteristics and mortality among patients admitted to the intensive care unit (ICU) following a suicide attempt.
Methods: Between January 2020 and May 2025, a total of 121 patients admitted to the ICU following a suicide attempt at three hospitals in a province of Türkiye were retrospectively reviewed. Demographic, clinical, and psychiatric data were extracted from medical records and analyzed to assess their associations with mortality.
Results: Male sex (with 96.3% of deceased cases being male) (aOR=35.402, 95% CI=1.821-688.370), jumping from a height (aOR=57.931, 95% CI=2.912-1152.486), and the absence of psychiatric consultation during ICU stay (aOR=150.134, 95% CI=10.590-2128.469) were all significantly associated with mortality. Patients who used the lethal methods had more extended ICU stays and were more frequently referred to locked psychiatric units. Mortality rates were significantly higher among those who did not receive a psychiatric consultation.
Conclusion: This retrospective study investigated key risk factors associated with mortality among patients admitted to the ICU following a suicide attempt. Advanced age, male sex, the presence of physical illness, use of high-lethality suicide methods, and the absence of psychiatric consultation were found to be the major factors that may contribute to mortality in this population. The findings suggest the critical importance of early identification of high-risk individuals, timely psychiatric assessment, and a multidisciplinary approach to intervention in reducing suicide-related mortality, although the results should be interpreted with caution given the limited number of events and retrospective design. Additionally, potential time-to-consultation biases warrant cautious interpretation.

Ethical Statement

The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Ethical approval was obtained from the Ethics Committee of Giresun Training and Research Hospital (Decision No: 23.07.2025/14).

References

  • Goodfellow B, Kolves K, De Leo D. Contemporary definitions of suicidal behavior: a systematic literature review. Suicid Life‐Threat Behav. 2019;49(2):488-504. doi:10.1111/sltb.12457
  • Pirkis J, Dandona R, Silverman M, Khan M, Hawton K. Preventing suicide: a public health approach to a global problem. Lancet Public Health. 2024;9(10):e787-e795. doi:10.1016/S2468-2667(24)00149-X
  • Weekly CC. World suicide prevention day-September 10, 2020. doi:10. 46234/ccdcw2020.191
  • World Health Organization. Suicide worldwide in 2021: global health estimates. Geneva, Switzerland: World Health Organization; 2025.
  • Klonsky ED, May AM, Saffer BY. Suicide, suicide attempts, and suicidal ideation. Ann Rev Clin Psychol. 2016;12(1):307-330. doi:10.1146/annurev-clinpsy-021815-093204
  • Glenn CR, Kleiman EM, Kellerman J, et al. Annual research review: a meta-analytic review of worldwide suicide rates in adolescents. J Child Psychol Psychiatr. 2020;61(3):294-308. doi:10.1111/jcpp.13106
  • Beghi M, Butera E, Cerri CG, et al. Suicidal behaviour in older age: A systematic review of risk factors associated to suicide attempts and completed suicides. Neurosci Biobehav Rev. 2021;127:193-211. doi:10. 1016/j.neubiorev.2021.04.011
  • Bachmann S. Epidemiology of suicide and the psychiatric perspective. Int J Environment Res Public Health. 2018;15(7):1425. doi:10.3390/ijerph 15071425
  • Kim SH, Kim HJ, Oh SH, Cha K. Analysis of attempted suicide episodes presenting to the emergency department: comparison of young, middle aged and older people. Int J Mental Health Systems. 2020;14:1-8. doi:10. 1186/s13033-020-00378-3
  • Hoertel N, Franco S, Wall MM, et al. Mental disorders and risk of suicide attempt: a national prospective study. Mol Psychiatr. 2015;20(6):718-726. doi: 10.1038/mp.2015.19
  • Rizk MM, Galfalvy H, Miller JM, et al. Characteristics of depressed suicide attempters with remitted substance use disorders. J Psychiatr Res. 2021;137:572-578. doi:10.1016/j.jpsychires.2020.10.041
  • Ivey-Stephenson AZ, Crosby AE, Hoenig JM, et al.Suicidal thoughts and behaviors among adults aged ≥18 years-United States, 2015-2019. MMWR Surveill Summ. 2022;71(1):1-19. doi:10.15585/mmwr.ss7101a1
  • Xu YE, Barron DA, Sudol K, Zisook S, Oquendo MA. Suicidal behavior across a broad range of psychiatric disorders. Mol Psychiatr. 2023;28(7):2764-2810. doi:10.1038/s41380-022-01935-7
  • Amiri S. Unemployment and suicide mortality, suicide attempts, and suicide ideation: a meta-analysis. Int J Mental Health. 2022;51(4):294-318. doi: 10.1080/00207411.2020.1859347
  • Øien-Ødegaard C, Hauge LJ, Reneflot A. Marital status, educational attainment, and suicide risk: a Norwegian register-based population study. Populat Health Metrics. 2021;19:1-11. doi: 10.1186/s12963-021-00263-2
  • Torino G, Rignanese M, Salmè E, et al. Physical pain and suicide-related outcomes across the lifespan: systematic review and meta-analysis. Psychiatr Res. 2025:116371. doi:10.1016/j.psychres.2025.116371
  • Onyeka IN, Maguire A, Ross E, O’Reilly D. Does physical ill-health increase the risk of suicide? A census-based follow-up study of over 1 million people. Epidemiol Psychiatr Sci. 2020;29:e140. doi:10.1017/s2045 796020000529
  • Prazak M, Bacigalupi R, Hamilton SC. Rural suicide: demographics, causes, and treatment implications. Comm Ment Health J. 2025;61(1):66-75. doi:10.1007/s10597-024-01327-x
  • Li L, Liu C, Tong Y, et al. Comparison of characteristics of suicide attempts registered in urban and rural areas in China. Front Psychiatr. 2022;12:805324. doi:10.3389/fpsyt.2021.805324
  • Ambar Akkaoui M, Chan-Chee C, Laaidi K, et al. Seasonal changes and decrease of suicides and suicide attempts in France over the last 10 years. Scientific Reports. 2022;12(1):8231. doi:10.1038/s41598-022-12215-3
  • Su MK, Chan PY, Hoffman RS. The seasonality of suicide attempts: a single poison control center perspective. Clin Toxicol (Phila). 2020; 58(11):1034-1041. doi:10.1080/15563650.2020.1733591
  • Tfifha M, Abbes W, Mahdhaoui W, et al. Effect of seasonality, climatic and temporal factors on suicide attempts amongst patients from southern tunisia. Eur Psychiatr. 2021;64(S1):S587-S587. doi:10.1192/j.eurpsy.2021.1566
  • Coimbra DG, Pereira ESAC, de Sousa-Rodrigues CF, et al. Do suicide attempts occur more frequently in the spring too? A systematic review and rhythmic analysis. J Affect Disord. 2016;196:125-37. doi:10.1016/j.jad.2016.02.036
  • Akkaya-Kalayci T, Vyssoki B, Winkler D, et al. The effect of seasonal changes and climatic factors on suicide attempts of young people. BMC Psychiatry. 2017;17(1):365. doi:10.1186/s12888-017-1532-7
  • Quesada-Franco M, Braquehais MD, Valero S, et al. A comparison of medically serious suicide attempters admitted to intensive care units versus other medically serious suicide attempters. BMC Psychiatry. 2022;22(1):805. doi:10.1186/s12888-022-04427-8
  • Renuka MK, Kalaiselvan MS, Arunkumar AS. An analysis of the predictors of mortality and morbidity in patients admitted after suicidal hanging to an Indian multidisciplinary intensive care unit. Indian J Anaesth. 2017;61(7):538-542. doi:10.4103/ija.IJA_170_17
  • Hirot F, Aminata A, Azouvi P, et al. Factors influencing the length of stay in a unit with mixed rehabilitation and psychiatric care after a suicide attempt by jumping: a cohort observational retrospective study. Eur J Physic Rehabil Med. 2022;58(5):749. doi:10.23736/S1973-9087.22.07341-5
  • El-Qawaqzeh K, Colosimo C, Bhogadi SK, et al. Unequal treatment? Confronting racial, ethnic, and socioeconomic disparity in management of survivors of violent suicide attempt. J Am College Surg. 2023;237(1):68-78. doi:10.1097/XCS.0000000000000716
  • Marwale AV, Phadke SS, Kocher AS. Psychiatric management of patients in intensive care units. Indian J Psychiatr. 2022;64(Suppl 2):S292-S307. doi:10.4103/indianjpsychiatry.indianjpsychiatry_28_22
  • Chung CH, Chien WC, Yeh HW, Tzeng NS. Psychiatric consultations as a modifiable factor for repeated suicide attempt-related hospitalizations: a nationwide, population-based study. J Affect Disord. 2021;278:157-164. doi: 10.1016/j.jad.2020.09.013
  • Son JM, Jeong J, Ro YS, et al. Effect of previous emergency psychiatric consultation on suicide re-attempts-a multi-center observational study. Am J Emerg Med. 2020;38(9):1743-1747. doi:10.1016/j.ajem.2020.05.030
  • Kim H, Kim Y, Shin M-H, et al. P68: Early psychiatric referral after attempted suicide helps prevent suicide reattempts: a longitudinal national cohort study in South Korea. Int Psychogeriatr. 2023;35(S1):244-245. doi:10.1017/S1041610223004064
  • Meyer HL, Reck T, Polan C, et al. A Comparison of severely injured patients after suicide attempts and violent crimes-a retrospective study of a level 1 trauma center. Clin Pract. 2024;14(4):1468-1477. doi:10.3390/clinpract14040118
  • Gilgoff JN, Wagner F, Frey JJ, Osteen PJ. Help-seeking and man therapy: the impact of an online suicide intervention. Suicid Life Threat Behav. 2023;53(1):154-162. doi:10.1111/sltb.12929
  • Che SE, Gwon YG, Kim KH. Follow-up timing after discharge and suicide risk among patients hospitalized with psychiatric illness. JAMA Network Open. 2023;6(10):e2336767-e2336767. doi:10.1001/jamanetwork open.2023.36767
  • Kim DW, Cho SE, Kang JM, et al. Risk factors for serious suicide attempts: difference between older and younger attempters in the emergency department. Front Psychiatr. 2021;11:607811. doi:10.3389/fpsyt.2020.607811
  • Freeman A, Mergl R, Kohls E, et al. A cross-national study on gender differences in suicide intent. BMC Psychiatry. 2017;17(1):234. doi:10. 1186/s12888-017-1398-8
  • Tai HC, Huang SH, Huang YC, et al. Gender differences in death during hospitalization following a survived suicide attempt in Taiwan from 1998 to 2015: a cross-sectional study. J Men’s Health. 2022;18(4):103. doi: 10.31083/j.jomh1804103
  • Conner A, Azrael D, Miller M. Suicide case-fatality rates in the United States, 2007 to 2014: a nationwide population-based study. Ann Int Med. 2019;171(12):885-895. doi:10.7326/M19-1324
  • Barry R, Rehm J, de Oliveira C, Gozdyra P, Chen S, Kurdyak P. Rurality as a risk factor for attempted suicide and death by suicide in Ontario, Canada. Canad J Psychiatr. 2022;67(9):679-689. doi:10.1177/ 07067437211053300
  • Mehanović E, Rosso G, Cuomo GL, et al. Risk factors for mortality after hospitalization for suicide attempt: results of 11-year follow-up study in Piedmont Region, Italy. Soc Psychiatr Psychiatr Epidemiol. 2024;59(6):1039-1051. doi:10.1007/s00127-023-02544-7
  • Akbarizadeh F, Hajivandi A, Hajivandi M, Zeidabadinejad MS. Marriage related suicide fatality rates. Iran J Psychiatry. 2019;14(1):54-59.
  • Barry R, Rehm J, de Oliveira C, Gozdyra P, Kurdyak P. Rurality and risk of suicide attempts and death by suicide among people living in four English-speaking high-income countries: a systematic review and meta-analysis. Canad J Psychiatr. 2020;65(7):441-447. doi:10.1177/ 0706743720902655
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There are 55 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Original Article
Authors

Meltem Hazel Şimşek 0000-0002-3323-4116

Ulaş Korkmaz 0000-0003-2392-6562

Publication Date October 25, 2025
Submission Date July 28, 2025
Acceptance Date October 13, 2025
Published in Issue Year 2025 Volume: 8 Issue: 6

Cite

AMA Şimşek MH, Korkmaz U. Retrospective evaluation of the demographic, psychiatric, and clinical characteristics of patients admitted to the intensive care unit following a suicide attempt. J Health Sci Med / JHSM. October 2025;8(6):1133-1142. doi:10.32322/jhsm.1752924

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