Suicide in adults within 30 days of discharge from hospital emergency department

Abstract

Suicide remains a frequent cause of death in adults, often overlooked despite known risk factors like mental disorders, older age, and chronic illness. Emergency department visits offer critical opportunities to identify suicidal ideation and provide preventive care. This study reviewed deaths within 30 days of discharge from the emergency department of a major public hospital in Alicante, Spain, focusing on deaths by suicide. Over five years, 529,312 emergency visits were recorded, with 453,599 patients (85.7%) discharged home. Of the 356 patients (0.078%) who died within 30 days post-discharge, 7 (1.97%) died by suicide. Among these, four had a psychiatric history, and one had a history of substance abuse, both established risk factors. The overall suicide rate among adults discharged from the emergency department was 1.54 per 100,000. Compared with those who died from other causes within 30 days of discharge, patients who died by suicide were younger (median age 72 vs. 83 years; p = 0.037, adjusted OR: 0.59, 95% CI: 0.34-1.03; p = 0.06), had a lower Charlson Comorbidity Index (median 3 vs. 6; p = 0.003), and were more often male (6/7 vs. 50.1%; p = 0.1). The presence of psychiatric history was the most significant risk factor for suicide within 30 days of discharge from the emergency department among patients aged 15 and older. Men were more likely than women to die by suicide, with the majority between the ages of 65 and 79. Notably, only one individual had a prior suicide attempt.