Risks for Suicide, Self-Harm Up for Adult ICU Survivors

Factors include previous depression or anxiety, previous PTSD, invasive mechanical ventilation

TUESDAY, May 11, 2021 (HealthDay News) — The risks for suicide and self-harm are increased for survivors of critical illness, according to a study published online May 5 in The BMJ.

Shannon M. Fernando, M.D., from the University of Ottawa in Ontario, Canada, and colleagues examined the correlation between survival from critical illness and suicide or self-harm after discharge in a population-based cohort study. Intensive care unit (ICU) hospital survivors (≥18 years) were compared to hospital survivors who never required ICU admission using linked administrative databases. Data were included for 423,060 consecutive ICU survivors (mean age, 61.7 years).

The researchers found that the crude incidence of suicide, self-harm, and the composite of suicide or self-harm was 41.4, 327.9, and 361.0, respectively, per 100,000 person-years among ICU survivors compared with 16.8, 177.3, and 191.6, respectively, in non-ICU hospital survivors. Compared with non-ICU hospital survivors, ICU survivors had higher risks for suicide and self-harm using weighted models (adjusted hazard ratios, 1.22 and 1.15, respectively). Factors associated with suicide or self-harm among ICU survivors included previous depression or anxiety, previous posttraumatic stress disorder, invasive mechanical ventilation, and renal replacement therapy (hazard ratios, 5.69, 1.87, 1.45, and 1.35, respectively).

“Patients and their loved ones shouldn’t be afraid if they need life-saving care in the ICU, as the rates of suicide we found are still very low,” Fernando said in a statement. “Our main message to patients is that it’s okay to not be okay after an ICU admission, and as physicians we’re becoming more aware of this.”

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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