İnci Meltem ATAY, Gözde BACIK YAMAN, Arif DEMİRDAS, ABDULLAH AKPINAR

Outcomes of suicide attempters in the emergency unit of a university hospital

Giriş: Bu çalışmada, bir üniversite hastanesi acil servisine başvuran intihar girişimi olgularının klinik izleme sonuçları ile birlikte değerlendirilmesi, intihar yöntemlerinin ve ilk/çoklu girişimlerin karşılaştırılması amaçlanmıştır. Yöntem: İntihar girişimi sonrası bir üniversite hastanesi acil servisine beş yıllık süreçte başvuran 640 olgunun kayıtları geriye dönük olarak incelenmiştir. Çalışmaya şu değişkenler alınmıştır: Demografik veriler, hastaneye başvuru tarihi, intihar girişimi sayısı, intihar girişimi özellikleri (yöntem, dürtüsel veya planlı girişim, intihar girişimi öncesi stres etkeninin varlığı, klinik izleme sonuçları, intihar girişiminden önce tanı konmuş psikiyatrik bozukluk varlığı). Yönteme göre ciddi ve ciddi olmayan girişimler ve ilk/çoklu girişimler ayrı ayrı karşılaştırılmıştır. Nominal değişkenlerin karşılaştırmasında ki-kare testi kullanılmıştır. Farklar 0.05 altında p değerleri için istatistiksel olarak anlamlı kabul edilmiştir. Bulgular: İntihar girişiminde bulunanların %66.3"ü kadındı ve çoğunlukla 15-24 ve 25-34 yaş grupları arasındaydı. En sık kullanılan yöntem ilaçla zehirlenmeydi (%84.5). En sık görülen intihar davranışı dürtüseldi (%82.5) ve genellikle ilk kez girişimde bulunanlardı. İlk kez intihar girişiminde bulunanların %71.9"u acil serviste izleme sonrasında taburcu edilmişti. İntihar yöntemine göre karşılaştırıldığında ciddi olmayan intihar yöntemleri 15-24 yaş grubu ve bekarlarda daha sıktı. Ciddi yöntemler sıklıkla yazın tercih edilmekteydi. Tüm intihar girişimlerinin %6.4"ü acil serviste izleme tedavisini redetmişti. Genellikle psikiyatrik bir bozukluk öyküsü olanlarda, çoğul girişimde bulunanlarda tedaviyi reddetme daha sıktı. Tartışma: Bulgularımız intihar girişiminde bulunanların sosyodemografik özellikleri açısından medeni durum dışında literatürle uyumluydu. Bununla birlikte genel acil servisteki tedavi redetmenin ciddi bir sorun olarak görünmesi, acil servislerde ileri önleyici stratejilerin yeniden

Bir üniversite hastanesi acil servisinde intihar giri?imi olgularının sonuçları

Objective: The aim of our study was to investigate the suicide attempters with the results of their clinical observations, to compare the suicide methods and first time/multiple attempts that resulted in admission to a university hospital emergency department in Turkey. Methods: The records of 640 patients admitted to a university hospital emergency department after a suicide attempt was reviewed retrospectively in a five year period. Following variables were included in the study: the demographic parameters, the date of admission, the number of attempts, features of the suicide attempts (methods, impulsive or planned attempts, stress factors before the attempts, the results of the clinical observations and the diagnosed mental disorders before the attempts). Non-violent and violent attempters according to the method and first time/multiple suicide were compared seperately. Chi-square test was used for comparing nominal variables. Differences were considered as statistically significant for p values under 0.05. Results: The majority of the suicide attempters were women (66.3%) and mostly between the age groups of 15-24 and 25-34. The most common method was self-poisining with drugs (84.5%). Most common suicide behaviour was impulsive (82.5%) and was likely to be the first-time attempters. First-time attempters were mostly (71.9%) discharged from the emergency department after a follow-up. According to the suicide method, non-violent suicide methods were more common in 15-24 age group and singles. Violent methods were frequently preferred in summer. Of all suicide attempters 6.4% were recorded as treatment refuse to the follow-up in the emergency unit. Treatment refusals were more common in multiple attempters who mostly have a mental disorder Conclusion: Our findings about the sociodemographic features of suicide attempters were consistent with the literature except the marital status. However treatment refuses in the common hospital emergency services seem to be serious problems that further preventive strategies should be reassessed in emergency units

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