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
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
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 nonpoisoning 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.
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 nonpoisoning 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.
참고문헌 (19)
- "Suicide prevention white paper" (2020)[URL]
- Parellada M, "Is attempted suicide different in adolescent and adults", Psychiatry Res, 157, pp.131~137 (2008)
- Hulten A, "Repetition of attempted suicide among teenagers in Europe : frequency, timing and risk factors", Eur Child Adolesc Psychiatry, 10, pp.161~169 (2001)
- Shain B, "Suicide and suicide attempts in adolescents", Pediatrics, 138, pp.e20161420~ (2016)
- Tejedor MC, "Attempted suicide : repetition and survival findings of a follow-up study", Acta Psychiatr Scand, 100, pp.205~211 (1999)
- Park JH, "Clinical analysis of the suicidal attempters visiting emergency center", J Korean Soc Emerg Med, 10, pp.568~578 (1999)
- 이미진, "소아의 응급질환 - 우리나라 소아 및 청소년의 손상과 급성 중독을 중심으로 -", Clinical and Experimental Pediatrics, 51(2), pp.116~121 (2008), 대한소아청소년과학회
- 곽영수, "응급실로 내원한 자의 손상 환자의 특징", 대한외상학회지, 22(1), pp.65~70 (2009), 대한외상학회
- Gummin DD, "2016 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 34th annual report", Clin Toxicol (Phila), 55, pp.1072~1252 (2017)
- 김진현, "의도적 중독으로 응급센터에 내원한 환자에 대한 연령별 비교 분석", 대한임상독성학회지, 14(2), pp.129~135 (2016), 대한임상독성학회[DOI]
- Zachariasse JM, "Validity of the Manchester Triage System in emergency care : a prospective observational study", PLoS One, 12, pp.e0170811~ (2017)
- 김혜영, "응급실 방문 자살기도자들의 기도 원인, 방법, 정신과적 진단에 대한 다기관 분석", 생물정신의학, 22(4), pp.187~194 (2015), 대한생물정신의학회
- Williams-Johnson J, "Suicide attempt by self-poisoning : characteristics of suicide attempters seen at the emergency room at the university hospital of the West Indies", West Indian Med J, 61, pp.526~531 (2012)
- 한철수, "10년간 응급의료센터에 내원한 소아청소년의 급성 중독에 대한 고찰 - 소아와 청소년중독의 임상적 차이 -", 대한응급의학회지, 24(6), pp.742~749 (2013), 대한응급의학회
- 방연식, "일 대학병원에 자살 시도 후 입원한 소아청소년들의 특성", 정신신체의학, 26(2), pp.135~144 (2018), 한국정신신체의학회[DOI]
- 곽명관, "약물중독 선별검사키트의 유용성", Acute and Critical Care, 24(2), pp.75~79 (2009), 대한중환자의학회
- 박상화, "의도적 자해에 의한 자살 성비", 보건정보통계학회지, 43(1), pp.113~118 (2018), 한국보건정보통계학회[DOI]
- 이정아, "Characteristics of Patients Who Visit the Emergency Department with Self-Inflicted Injury", Journal of Korean Medical Science, 27(3), pp.307~312 (2012), 대한의학회
- Howson MA, "Re-presentation and suicide rates in emergency department patients who self-harm", Emerg Med Australas, 20, pp.322~327 (2008)