A Retrospective Analysis of Suicide Attempts Presenting to the Emergency Department

Abstract

Objective: Suicide attempts remain a major public health concern worldwide and account for a substantial proportion of emergency department (ED) admissions. Emergency departments play a critical role in both the acute medical stabilization and the psychiatric assessment of patients following suicide attempts. The aim of this study was to retrospectively evaluate the sociodemographic and clinical characteristics of patients presenting to a university hospital emergency department due to suicide attempts, to describe the methods used, and to assess factors associated with in-hospital outcomes. Materials and Methods: This retrospective, descriptive study included patients aged 18 years and older who presented to a university hospital emergency department due to suicide attempts between January 2020 and September 2025. Cases were identified through the hospital information system using relevant keywords and ICD diagnostic codes. Demographic variables (age, sex, marital status, educational level, and employment status), clinical characteristics (psychiatric diagnosis and family history of suicide), and attempt-related features (number of attempts and method used) were recorded. In-hospital outcomes were classified as discharge or death. Statistical analyses were performed using IBM SPSS Statistics version 27.0. Continuous variables were compared using the Student’s t-test or Mann–Whitney U test, as appropriate, while categorical variables were analyzed using the chi-square test or Fisher–Freeman–Halton exact test. A p-value <0.05 was considered statistically significant. Results: A total of 1,544 patients were included in the study. The mean age was 37.74±14.77 years, and 47.4% of the patients were female. Overall, 57 patients (3.7%) died during in-hospital follow-up. Patients in the deceased group were significantly older than those who were discharged (41.80±15.32 vs. 37.59±14.73 years, p=0.032). The method of suicide attempt was significantly associated with in-hospital mortality (p=0.001), with higher death rates observed in high-lethality methods such as hanging and jumping from height. Educational level also differed significantly between groups (p=0.043). No statistically significant differences were found between the groups in terms of sex, marital status, employment status, psychiatric diagnosis, number of attempts, or family history of suicide. Conclusion: In this study, in-hospital mortality following suicide attempts was associated with older age, the lethality of the method used, and educational level. These findings underscore the importance of method- and age-based risk assessment in the emergency department and highlight the need for closer monitoring and targeted preventive strategies for high-risk patients.

Keywords

• Suicide
• Emergency Service
• Risk Factors
• Mental Disorders
• Retrospective Studies

Acil Servise Başvuran İntihar Vakalarının Retrospektif Analizi

Abstract

Amaç: İntihar girişimleri, dünya genelinde önemli bir halk sağlığı sorunu olmaya devam etmekte olup, acil servis başvurularının kayda değer bir bölümünü oluşturmaktadır. Acil servisler, intihar girişimi sonrası hastaların hem akut tıbbi stabilizasyonu hem de ruhsal değerlendirilmesi açısından kritik bir rol üstlenmektedir. Bu çalışmanın amacı, bir üniversite hastanesi acil servisine intihar girişimi nedeniyle başvuran hastaların sosyodemografik ve klinik özelliklerini retrospektif olarak incelemek, kullanılan yöntemleri ortaya koymak ve hastane içi sonlanımla ilişkili faktörleri değerlendirmektir. Gereç ve Yöntem: Bu retrospektif ve tanımlayıcı çalışma, Ocak 2020–Eylül 2025 tarihleri arasında bir üniversite hastanesi acil servisine intihar girişimi nedeniyle başvuran 18 yaş ve üzeri hastaları kapsamaktadır. Olgular, hastane bilgi yönetim sistemi üzerinden ilgili anahtar sözcükler ve ICD tanı kodları kullanılarak belirlenmiştir. Hastalara ait yaş, cinsiyet, medeni durum, eğitim düzeyi ve çalışma durumu gibi demografik veriler ile psikiyatrik tanı öyküsü, ailede intihar öyküsü, girişim sayısı ve kullanılan intihar yöntemi kaydedilmiştir. Hastane içi sonlanımlar taburcu ve exitus olarak sınıflandırılmıştır. İstatistiksel analizler IBM SPSS Statistics sürüm 27.0 kullanılarak yapılmış; sürekli değişkenler için Student t-testi veya Mann–Whitney U testi, kategorik değişkenler için ki-kare testi veya Fisher–Freeman–Halton exact testi uygulanmıştır. İstatistiksel anlamlılık düzeyi p<0,05 olarak kabul edilmiştir. Bulgular: Çalışmaya toplam 1544 hasta dahil edilmiştir. Hastaların yaş ortalaması 37,74±14,77 yıl olup, %47,4’ü kadındır. Hastaların 57’si (%3,7) hastane içi izlemde exitus ile sonuçlanmıştır. Exitus grubundaki hastaların yaş ortalaması taburcu edilenlere göre anlamlı olarak daha yüksektir (41,80±15,32 vs. 37,59±14,73; p=0,032). Kullanılan intihar yöntemi hastane içi mortalite ile anlamlı ilişki göstermiştir (p=0,001); özellikle ası ve yüksekten atlama gibi yüksek letaliteli yöntemlerde exitus oranları daha yüksek bulunmuştur. Eğitim durumu ile hastane içi sonlanım arasında da anlamlı fark saptanmıştır (p=0,043). Cinsiyet, medeni durum, çalışma durumu, psikiyatrik tanı, girişim sayısı ve aile öyküsü açısından gruplar arasında anlamlı fark izlenmemiştir. Sonuç: Bu çalışmada, intihar girişimi sonrası hastane içi mortalitenin ileri yaş, kullanılan yöntemin letalitesi ve eğitim düzeyi ile ilişkili olduğu gösterilmiştir. Bulgular, acil serviste intihar girişimiyle başvuran hastalarda özellikle yöntem ve yaş temelli risk değerlendirmesinin önemini vurgulamakta ve yüksek riskli olgular için daha yoğun izlem ve önleyici stratejilerin gerekliliğine işaret etmektedir.

Keywords

• İntihar
• Acil Servis
• Risk Faktörleri
• Psikiyatrik Hastalık
• Retrospektif Analiz

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