ArticleAmerican journal of preventive medicine2022
Suicide Risk Among Hospitalized Versus Discharged Deliberate Self-Harm Patients: Generalized Random Forest Analysis Using a Large Claims Data Set.
Article in American journal of preventive medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 26 citations in OpenAlex.
- Psychiatric inpatient bed capacity and suicide mortality in Sweden: a nationwide ecological study.The Lancet regional health. Europe · 2026Article
- Impact of the 2017 mental health act revision on suicide attempts: evidence from emergency department data in Korea.BMC public health · 2026Article
- Suicide deaths among reproductive-aged women in the US post-Dobbs: a national time-series analysis.Social psychiatry and psychiatric epidemiology · 2025Article
- Beyond risk: rethinking hospitalization for suicidal individuals.Frontiers in psychiatry · 2025Article
- Suicide risk following ED presentation with self-harm varies by hospital.Social psychiatry and psychiatric epidemiology · 2024Article
- Article
- Estimated Average Treatment Effect of Psychiatric Hospitalization in Patients With Suicidal Behaviors: A Precision Treatment Analysis.JAMA psychiatry · 2024Article
- Machine learning-based causal models for predicting the response of individual patients to dexamethasone treatment as prophylactic antiemetic.Scientific reports · 2023Article
- Incidence and Correlates of Emergency Department Visits for Deliberate Self-Harm Among Asian American Youth.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2023Article
- Machine-learning identified suicide risk and emergency department inpatient admission.General hospital psychiatryArticle
- Emergency Department Management of Suicidal Ideation: Challenges, Misperceptions, and Hope.Missouri medicineArticle
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
introductionSuicide rates are extremely high among emergency department patients seen for deliberate self-harm. Inpatient hospitalization is often recommended for these patients, but evidence on the suicide prevention impacts of hospitalization is scarce. Confounding by indication and challenges to implementing randomized designs are barriers to advances in this field.
methodsInvestigators used 2009-2012 statewide data on 57,312 self-harm emergency department patients from California, linked to mortality records. Naive 12-month and 30-day suicide risks were estimated among patients who were hospitalized versus those who were discharged. Then, generalized random forest methods were applied to estimate the average treatment impacts of hospitalization on suicide, conditioning on observable covariates. Associations were calculated separately for sex- and age-specific subgroups. Analyses were conducted in February 2019-August 2021.
resultsIn naive analyses, suicide risk was significantly higher in hospitalized than in discharged patients in each subgroup. In 12-month models accounting for the observed covariates through generalized random forest methods, hospitalized male patients had 5.4 more suicides per 1,000 patients (95% CI=3.0, 7.8), hospitalized patients aged 10-29 years had 2.4 more suicides per 1,000 (95% CI=1.1, 3.6), and those aged ≥50 years had 5.8 more suicides per 1,000 (95% CI=0.5, 11.2) than corresponding discharged patients. Hospitalization was not significantly associated with suicide among female patients or patients aged 30-49 years in generalized random forest analyses. Patterns were similar in 30-day generalized random forest models.
conclusionsEmergency department personnel intend to hospitalize self-harm patients with high suicide risk; this study suggests that this goal is largely realized. Analyses that control for confounding by observable covariates did not find clear evidence that hospitalization reduces suicide risk and could not rule out the possibility of iatrogenic effects.
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