청소년 자살시도 환자의 임상적 특성 및 예후 연관 요인: 중독 대 비중독
Clinical features of adolescents with suicide attempt and the factors associated with their outcomes: poisoning versus non-poisoning
이명훈, 장재호, 조진성, 최우성, 최재연,
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이명훈 ( Lee Myoung-Hoon )
Gachon University College of Medicine Gachon University Gil Medical Center Department of Emergency Medicine
장재호 ( Jang Jae-Ho )
Gachon University College of Medicine Gachon University Gil Medical Center Department of Emergency Medicine
조진성 ( Cho Jin-Seong )
Gachon University College of Medicine Gachon University Gil Medical Center Department of Emergency Medicine
최우성 ( Choi Woo-Sung )
Gachon University College of Medicine Gachon University Gil Medical Center Department of Emergency Medicine
최재연 ( Choi Jea-Yeon )
Gachon University College of Medicine Gachon University Gil Medical Center Department of Emergency Medicine
Abstract
Purpose: Methods for suicide attempt are largely divided into poisoning and non-poisoning, which differ in clinical features and severity. We aimed to investigate the clinical features of adolescents with suicide attempt and factors associated with poor outcomes from the 2 methods.
Methods: A retrospective study was conducted on adolescents (10-18 years) who visited the emergency department after suicide attempt from 2011 through 2018. The adolescents were divided into the poisoning and non-poisoning groups. We analyzed the differences of clinical features and outcomes between the 2 groups. Poor outcomes were defined as hospitalization to the intensive care unit or death. Factors associated with poor outcomes were investigated using multivariable logistic regression.
Results: Of 4,335 adolescents in total, 2,134 (49.2%) were categorized as the poisoning group. In this group, the adolescents with poor outcomes used acetaminophen most frequently (26.5%), followed by sedative or antipsychotics (22.3%). In the non-poisoning group, those with the outcomes used fall from height (73.2%) most commonly, followed by hanging (21.0%). The factors associated with the outcomes were age (for increment of 1 year; odds ratio, 1.11; 95% confidence interval, 1.02-1.22) in the poisoning group, and being boys (1.34; 1.03-1.73) and non-use of alcohols (2.87; 1.73-4.74) in the non-poisoning group.
Conclusion: In adolescents who used poisoning for suicide attempt, increasing age is associated with poor outcomes. The outcomes are associated with being boys and non-use of alcohols in those who used non-poisoning methods.
키워드
Adolescent; Child; Emergency Service, Hospital; Poisoning; Suicide, Attempted; Wounds and Injuries
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