在急诊室的儿童自杀风险
David Pagliaccio1,2, Jaclyn S Kirshenbaum1, Katherine M Keyes3
1Department of Psychiatry, Columbia University, New York, New York.
JAMA network open
|July 22, 2025
概括
到急诊室 (ED) 的儿童的自杀行为很常见,并且与经常性访问有关,特别是在出院后的几个月内. 识别风险因素对于改善护理和预防未来发生的情况至关重要.
科学领域:
- 儿科急救医学 儿科急救医学
- 儿童和青少年精神病学 儿童和青少年精神病学
- 公共卫生 公共卫生
背景情况:
- 年轻人中自杀率正在上升,使自杀思想和行为 (STB) 成为一个关键的公共卫生问题.
- 进入急诊室 (ED) 的STB儿童面临重复性精神健康 (MH) 问题的高风险.
研究的目的:
- 为了确定美国EDS中儿童中STB的发病率.
- 为了确定与重复ED访问的风险因素相关的儿童群体的STB.
主要方法:
- 一项回顾性队列研究分析了来自12个州 (2010-2020) 的电子健康记录.
- 国际疾病分类 (ICD) 代码将STB与其他心理健康 (MH) 访问区分开来.
- 数据链接允许在多次ED访问中跟踪患者.
主要成果:
- 超过1000万次ED访问被选,在374,118名独一无二的儿童中,在92,863次访问中 (1%) 发现了STB.
- 从2010年到2020年,STB访问量大幅增加.
- 患有性病的患者更有可能拥有私人保险,并且居住在收入较高的地区.
- 经常性STB访问是常见的,其中62%发生在出院后3个月内.
- STB强烈预测STB的返回ED访问 (aOR,9.71).
结论:
- 性病是儿科ED的一个重要问题,在初次呈现后不久就有很高的复发率.
- 诸如女性性别,增加MH并发症,较长的初次访问和缺乏私人保险等因素与回归STB访问有关.
- 了解这些风险因素对于有针对性的干预措施和改善患有性传播疾病的儿童的后续护理至关重要.
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