Suicide and Self-Harm in Children and Adolescents Admitted to PICUs in the United States. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: McCluskey, Casey K.; Klein, Margaret J.; Steward, Sarah C.; Rotta, Alexandre T.
• Is Part Of: Pediatric critical care medicine. Volume 23:Issue 1(2022)
• Publication Date: 2022-01
• Subjects: adolescent -- children -- pediatric intensive care unit -- self-harm -- suicide; Pediatric intensive care -- Periodicals; Pediatric emergencies -- Periodicals; 618.05
• DOI: 10.1097/PCC.0000000000002836
• Languages: English
• ISSNs: 1529-7535

Abstract

Abstract : OBJECTIVES: To characterize the epidemiology of children and adolescents admitted for deliberate self-harm to PICUs in the United States by examining patient demographics, diagnoses, modes of self-harm, and outcomes. DESIGN: Descriptive analysis of a large, multicenter, quality-controlled database. SETTING: The 137 PICUs participating in the Virtual Pediatric Systems database during the study period. PATIENTS: Children between 6 and 18 years old admitted to a participating PICU from January 1, 2009, to December 31, 2017, with a diagnosis involving deliberate self-harm or a suicide attempt. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 9, 197 admissions for self-harm, females accounted for 6, 740 (73.3%), whereas males incurred 174 of the 284 deaths (61.3%). Admissions for self-harm doubled over the study period (0.56% in 2009 vs 1.13% in 2017), with an increase observed across every age group. After PICU care, most patients were transferred to a general care floor (51.1%) or to a psychiatric rehabilitation facility (31.8%). Intentional drug ingestion (84%) was the most common mode of self-harm but was associated with less than 1% of the fatalities. Asphyxia/hanging or firearms were a factor in 411 (4.5%) and 106 (1.2%) of the admissions but were associated with 117 (28.5%) and 55 (51.9%) of the deaths, respectively. CONCLUSIONS: PICU admissions due to self-harm increased for all age groups during the study period. Females accounted for most of these admissions, whereas males accrued most of the in-hospital deaths. Intentional drug ingestion was the most common mode of self-harm and was rarely fatal, whereas asphyxia and firearms were the mechanisms associated with the highest mortality. Abstract : Supplemental Digital Content is available in the text.