511 - Clinical Characteristics of Suicide and Predictors of Recurrent Suicide in Pediatric Emergency Departments: A Retrospective Study

Publication Number: 511.4496

Mei Hua Hu, Chang Gung Memorial Hospital and Chang Gung University, LinKou, New Taipei, Taiwan (Republic of China); Go-Shine Huang, Tri Service General Hospital, Taipei, Taipei, Taiwan (Republic of China)

Background: Suicide among children and adolescents is a critical public health concern, with rates increasing in recent years. Pediatric emergency departments (PEDs) play a crucial role in identifying, assessing, and managing these cases. A shortage of inpatient psychiatric beds for children and adolescents highlights a significant gap in the global mental health care system.

Objective: This study aims to explore the characteristics of suicide attempts or ideation, and predictive factors of recurrent suicide attempts among patients presenting to the PED.

Design/Methods: This retrospective observational study included children admitted to the PED for suicide attempts or ideations. Electronic health records from January 2011 to October 2021 were reviewed. Univariate and multivariate logistic regression models were used to evaluate factors associated with recurrent suicide attempts or ideations.

Results: Of the total of 209 visits admitted to PED, 139 patients (mean age 16.17 ± 1.58 years, 108 (77.7%) female, 31 (22.3%) male were diagnosed with suicide attempt or suicide ideation. Of these patients, 37 (26.6%) had recurrent presented to PED. Univariate analysis revealed hallucination (odds ratio [OR]:3.06, confidence interval CI: 1.30-7.24), school bulling (OR: 2.385, CI:1.10-5.18), stress (OR:2.91, CI: 1.23-6.89), and discharge against medical advice (OR: 6.29, CI: 2.42-6.32) were associated with recurrent presented to PED. Multivariate analysis revealed discharge against medical advice (OR: 3.436, CI: 1.24-9.49) is independent predictor of recurrent suicide.

Conclusion(s): Discharge against medical advice is the independent predictor of the recurrent suicide presenting to PED. Pediatric emergency physicians might have a suitable setting for initiating suicide prevention efforts and delivering PED-initiated suicide prevention interventions to suicidal child or adolescents.