Recorded presentation

Lynne Fullerton-Gleason, PhD¹, Jonathon LaValley, BS², and G. Thomas Shires, MD¹. (1) Trauma Institute, University of Nevada School of Medicine, 716 California SE, Albuquerque, NM 87108-3708, 505-266-7518, lfullerton@salud.unm.edu, (2) Department of Emergency Medicine, University of New Mexico, MSC10 5560, 1 University of New Mexico, Albuquerque, NM 87131-0001

Purpose: to identify mortality risk among hospital patients.

Methods: We linked Nevada hospital and vital statistics 1995-2000 databases and calculated: 1) percentage of patients admitted to hospitals who died; 2) percentage of decedents with a hospital admission; 3) odds of death, by cause, among patients with prior admission for suicide. Patient injury type was coded for each UHDDS as follows: patients with an admission for suicide were coded as suicide patients; those remaining were coded, in order of priority, as assault, unintentional injury, undetermined/other injury, and non-injury patients.

Results: Among 89,932 decedents, 48,957 (54%) had been admitted to a hospital. Cause of death for this subsample was suicide (n=511), assault (120), unintentional injury (946), other/undetermined (75), and non-injury (47,305). Among suicide decedents, most (87%) had no suicide ECode listed for any prior admission.

Mortality rate among UHDDS suicide patients (57/1,000) was higher than for assault patients (29/1,000), but lower than among unintentional injury (69/1,000) and non-injury (81/1,000) patients. Cause of death among patients admitted for suicide was most often suicide (50%), followed by non-injury (39%), unintentional injury (6%), other/undetermined (3%) and homicide (2%).

Among decedents, the odds of suicide death among those with prior suicide admissions was 109 times those with no prior suicide admissions (OR=109;95%CI=76,157). Suicide patients also had higher odds of death from homicide (OR=9;95%CI=2,31), unintentional (OR=3.2;95%CI=1.4,6.8), and undetermined/other injury (OR=20.8;95%CI=6.4, 60.3).

Conclusions: Most decedents have prior hospital admissions, suggesting an opportunity for clinical intervention. Prior suicide admission is a significant risk factor for injury death.

Learning Objectives: At the conclusion of this session, participants will

• understand the relationship between hospital admission for suicide and subsequent injury death;
• identify the proportion of decedents, by cause of death, for whom hospital-based prevention initiatives could be effective;
• discuss why patients presenting for reasons other than suicide are potential targets for suicide screening; and 4)articulate the distinct value of analyzing linked databases relative to analysis of any individual database.

Keywords: Suicide, Data/Surveillance

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation