Abstract
Suicide frequency has tripled for some pediatric age groups over the last decade, of which, serious attempts result in pediatric intensive care unit (PICU) admissions. We paired clinical, aggregate geospatial, and temporal demographics to understand local community variables to determine if epidemiological patterns emerge that associate with risk for PICU admission. Data were extracted at an urban, high-volume, quaternary care facility from January 2011 to December 2017 via ICD 10 codes associated with suicide. Clinical, socioeconomic, geographical, and temporal variables were reviewed. In total, 1036 patients over the age of 9 were included, of which n = 161 were PICU admissions. Females represented higher proportions of all suicide-related hospital admissions (67.9%). Looking at race/ethnicity, PICU admissions were largely Caucasian (83.2%); Blacks and Hispanics had lower odds of PICU admissions (OR: 0.49; 0.17, respectively). PICU-admitted patients were older (16.0 vs. 15.5; p = 0.0001), with lower basal metabolic index (23.0 vs. 22.0; p = 0.0013), and presented in summer months (OR: 1.51, p = 0.044). Time-series decomposition showed seasonal peaks in June and August. Local regions outside the city limits identified higher numbers of PICU admissions. PICUs serve discrete geographical regions and are a source of information, when paired with clinical geospatial/seasonal analyses, highlighting clinical and societal risk factors associated with PICU admissions.
Highlights
Suicide is defined by the Centers for Disease Control as death caused by injuring oneself with the intent to die and is part of a broader class of behaviors called self-directed violence, that is a behavior that could result in immediate injury and has potential for lasting injury [1]
The results presented are intended for pediatric intensive care unit (PICU) staff, pediatricians, social workers, chaplains, suicide researchers, parents, educators, psychologists, those working in adolescent community outreach, and mental health fields
Patients admitted to the PICU have a consistently higher median age, with a more skewed distribution leading to higher densities at older ages
Summary
Suicide is defined by the Centers for Disease Control as death caused by injuring oneself with the intent to die and is part of a broader class of behaviors called self-directed violence, that is a behavior that could result in immediate injury and has potential for lasting injury [1]. A serious suicide attempt (SSA) is one that would result in death without specialized intervention (surgery, antidotes, intensive care unit (ICU) admission, prolonged hospitalization), and can be considered a proxy for completed suicide in surviving individuals [2]. Patients that originate from these regions are being exposed to a unique set of geographical and temporal factors that need better understanding and characterization In this retrospective chart review, we extracted clinical and community variables available in the electronic medical record (EMR) to develop a more complete understanding of factors that associate with PICU admission (non-ICU hospitalized patients were used as our comparative-control group). The results presented are intended for PICU staff, pediatricians, social workers, chaplains, suicide researchers, parents, educators, psychologists, those working in adolescent community outreach, and mental health fields
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