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Table 5 Characteristics of physician-diagnosed suicide attempts and non-suicidal intentional self-harm treated in EDs

From: Multi-site medical record review for validation of intentional self-harm coding in emergency departments

 

Maryland

N = 202

Colorado

N = 226

Massachusetts

N = 357

Known non-suicidal

(N = 49)

%

Known suicidal

(N = 131)

%

Odds ratios*

(95% CI)

Non-suicidal

(N = 32)

%

Suicidal

(N = 175)

%

Odds ratios*

(95% CI)

Non-suicidal

(N = 121)

%

Suicidal

(N = 203)

%

Odds ratios*

(95% CI)

Variables from the medical record

Mean age (SD)a

23.9 (12.9)

31.3 (16.0)

 

26.0 (12.7)

28.9 (14.7)

 

26.7 (12.4)

31.1 (14.7)

 

Femalea

55.1

49.6

 

59.4

60.0

 

59.5

66.0

 

Acute injury

77.6

73.3

 

62.5

54.3

 

97.5

94.6

 

Drug poisoning mechanismb

16.3 (8)

49.6

5.0 (2.2–11.6)

34.4

57.7

2.6 (1.1–6.3)

7.4

65.0

23.1 (11.1–48.4)

Cut/pierce mechanismb

59.2

24.4

0.2 (0.1–0.5)

53.1

26.3

0.31 (0.14–0.73)

72.7

16.7

.08 (0.04–0.13)

Suicidal ideation

24.5

77.1

10.4 (4.8–22.4)

50.0

92.6

12.5 (4.6–33.4)

32.2

69.5

4.8 (2.9–7.8)

Risk evaluation and used an assessment tool

59.2

63.4

 

65.6

65.1

 

39.2

47.5

 

Safety or counseling plan

71.4

79.8

 

93.8

94.3

 

77.7

89.2

 

Personal history of self-harm

46.9

59.5

 

56.3

55.4

 

66.9

54.2

0.58 (0.37–0.93)

Prior psychiatric hospitalization

32.7

33.1

 

27.4

 

29.8

38.9

 

Mental health therapy and/or medication

59.2

57.3

 

53.1

62.9

 

64.5

61.6

 

Blood alcohol 80 + mg/100 ml

7.1 (3)

22.1

3.7 (1.01–13.4)

16.3

 

12.3

4.1 (1.4–12.0)

Drugs other than alcohol

33.3

42.3

 

56.6

 

18.2

31.0

 

2 or more personal factors or circumstances

79.6

90.8

2.5 (1.02–6.3)

81.3

88.6

 

83.5

90.1

 

Variables from ED billing record

 Drug poisoning codesb,c

n/a

n/a

 

37.5

69.2

3.7 (1.6–9.1)

61.6

26.1 (11.6–58.9)

 Cut/pierce codesb,c

n/a

n/a

 

50.0

21.2

0.3 (0.1–0.7)

70.2

17.2

.09 (.05–.15)

 Suicidal ideation (R45.851 code)

n/a

n/a

 

24.5

 

21.5

18.2

 

 Personal history of self-harm (Z91.5 code)

n/a

n/a

 

13.1

 

6.6

4.9

 

 Unspecified suicide attempt (T14.91 code)

n/a

n/a

 

15.4

 

15.3

7.1 (2.1–23.7)

 Not discharged homed

n/a

n/a

 

74.9

7.6 (3.1–20.0)

31.4

66.5

4.3 (2.7– 7.0)

  1. % percentage, CI confidence interval, SD standard deviation, n/a not available, —Censored per data use agreement
  2. CO: Known intentional self-harm of whom 28 are suspected suicidal (16% of 175) and 25 suspected of non-suicidal intentional self-harm (78% of 32). MA: Known intentional self-harm with suspected or known combined for each type (suicidal or not)
  3. *Shown are odds ratios that do not include 1. The referent group was the non-suicidal intentional self-harm group, based on physician diagnosis
  4. aColorado and Massachusetts: information from the ED billing record, not the medical record
  5. bIf a person attempted a drug overdose and cut/pierce on the same occasion that person is counted twice, once in each category
  6. cCO missing n = 29 (14%) of the 207
  7. dCO missing n = 4 of 207