The association between recency of suicide attempt and reattempt in adult emergency department patients

Authors

• T Shi
• R Merai
• C Farmer
• A Wei
• E Boudreaux
• M Pao
• J Bridge
• LM Horowitz

Abstract

While a prior suicide attempt (SA) is known to be a strong predictor of future attempts, there are limited data on how recency of a prior attempt is associated with risk of future attempts. This study aimed to describe the association between recency of a prior SA and reattempt 1-year post-discharge in adults presenting to an emergency department (ED).

This secondary analysis of data from the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) study included patients who were screened using the Patient Safety Screener and were assessed for reattempt 52 weeks post-discharge through telephone interviews and chart review. Demographics (sex, age, race/ethnicity) were self-reported. Binary logistic regressions assessed the relationship between recency of a prior attempt and reattempt.

Data were analyzed from 638 patients aged 18-93 years old (mean[SD]=36.3[12.7] years, 56.6% female, 65.8% non-Hispanic white). At baseline, 65.4% of patients reported a past SA and 96.6% reported suicidal ideation in the last two weeks. During the follow-up period, 18.0% of patients reattempted suicide. Compared to those who have never attempted, participants who attempted in the month prior to index visit had 2.6 times (95%CI: 1.3–5.1, z=2.79, p<0.01) higher odds of reattempting within the following year.

This suggests that ED patients presenting with an attempt as recent as 1 month may require more extensive interventions compared to those with less recent attempts. These findings could impact suicide risk clinical pathways by providing risk parameters for managing patients who screen positive with a past SA history.

Scientific Focus Area: Clinical Research

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