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Multicenter Study of Predictors of Suicide Screening in Emergency Departments
Author(s) -
Ting Sarah A.,
Sullivan Ashley F.,
Miller Ivan,
Espinola Janice A.,
Allen Michael H.,
Camargo Carlos A.,
Boudreaux Edwin D.
Publication year - 2012
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2011.01272.x
Subject(s) - medicine , suicidal ideation , poison control , suicide prevention , interquartile range , suicide attempt , triage , emergency department , confidence interval , logistic regression , psychological intervention , injury prevention , psychiatry , emergency medicine , family medicine
Objectives: The objective was to provide estimates and predictors of screening for suicide in emergency departments (EDs). Methods: Eight geographically diverse U.S. EDs each performed chart reviews of 100 randomly selected patients, ages 18 years or older, with visits in October 2009. Trained chart abstractors collected information on patient demographics, presentation, discharge diagnosis, suicide screening, and other mental health indicators. Univariate logistic regression was used to determine factors associated with suicide screening. Results: The cohort of 800 patients had a median age of 41 years (interquartile range = 27 to 53 years) with 57% female, 16% Hispanic, 58% white, 23% black or African American, and 10% other race. Suicide screenings were documented for 39 patients (4.9%; 95% confidence interval [CI] = 3.4% to 6.4%). Of those screened, 23 (2.9% of total sample; 95% CI = 1.7% to 4.0%) were positive for suicidal ideation or behavior. Approximately 90% of those screened had documented complaints of a psychiatric nature at triage. About one‐third had either documentation of alcohol abuse (33%) or intentional illegal or prescription drug misuse (36%). Conclusions: The presence of known psychiatric problems and substance use had the strongest associations with suicide screening, yet even patients presenting with these indicators were not screened for suicide. Understanding factors that currently influence suicide screening in the ED will guide the design and implementation of improved suicide screening protocols and related interventions. ACADEMIC EMERGENCY MEDICINE 2012; 1–5 © 2012 by the Society for Academic Emergency Medicine