Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun 30;2(2):95-103.
doi: 10.15441/ceem.15.013. eCollection 2015 Jun.

Epidemiology and outcomes of out-of-hospital cardiac arrest according to suicide mechanism: a nationwide observation study

Soo Jin Kim  1 , Sang Do Shin  2 , Eui Jung Lee  2 , Young Sun Ro  3 , Kyoung Jun Song  2 , Seung Chul Lee  4 ; CardioVascular Disease Surveillance (CAVAS) investigators
Affiliations

Epidemiology and outcomes of out-of-hospital cardiac arrest according to suicide mechanism: a nationwide observation study

Soo Jin Kim et al. Clin Exp Emerg Med. .

Abstract

Objective: Suicide remains a serious, preventable public health problem. This study aims to describe the epidemiological characteristics associated with various suicide methods and to investigate outcomes after suicide-associated sudden cardiac arrest (S-SCA), stratified by different suicide attempt methods.

Methods: An S-SCA database was constructed from ambulance run sheets and augmented by a review of hospital medical records from 2008 to 2010 in Korea. The cases with non-cardiac etiologies and suicide attempts were initially extracted. Suicide attempts were classified as hanging, poisoning, fall, and other. The primary end point was survival to discharge. Age- and sex-adjusted incidence rates were calculated for each suicide method. Adjusted odds ratios for outcome were calculated with adjustments for potential confounding variables.

Results: A total 5,743 patients were analyzed as S-SCAs. The most common method of suicide attempt was hanging (58.7%), followed by falls (17.6%), poisoning (17.5%), and others (5.8%). The survival to discharge rates were 2.1% (n=119) overall, 2.4% in hanging, 2.4% in poisoning and 0.5% in fall, respectively. The age- and sex-adjusted incidence rates (male/female) per million persons was 32.7 (35.8/29.7) in 2008, 41.8 (46.0/37.7) in 2009, and 43.0 (50.1/36.0) in 2010. Compared with hanging, adjusted odds ratios (95% confidence intervals) for survival to discharge was 1.05 (0.60 to 1.83) for poisoning and 0.08 (0.03 to 0.21) for falls.

Conclusion: In this nationwide S-SCA cohort study from 2008 to 2010, the standardized incidence rate increased annually. However, the rate of survival to discharge remains very low.

Keywords: Emergency medical services; Heart arrest; Incidence; Outcome; Suicide.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Study population and outcomes. EMS, emergency medical service; OHCA, out-of-hospital cardiac arrest.
Fig. 2.
Fig. 2.
Distribution and trend line of suicide-associated sudden cardiac arrests. (A) Distribution by month, weekday, and time of the event. (B) Monthly trend of suicide-associated sudden cardiac arrest by year and month. HH, hour.
See this image and copyright information in PMC

References

    1. Yaniv G. Suicide intention and suicide prevention: an economic perspective. J Socio Econ. 2001;30:453–68.
    1. Mann JJ, Apter A, Bertolote J, et al. Suicide prevention strategies: a systematic review. JAMA. 2005;294:2064–74. - PubMed
    1. World Health Organization . Country reports and charts [Internet] Geneva: World Health Organization; 2005. [cited 2015 May 19]. Available from: http://www.who.int/mental_health/suicide-prevention/en/
    1. Organization for Economic Cooperation and Development . OECD health data 2009. Paris: Organization for Economic Cooperation and Development; 2009.
    1. Heming N, Serve E, Weiss N, et al. Drowning after falling from a medium-height bridge: multiple trauma victims. Prehosp Emerg Care. 2012;16:356–60. - PubMed

LinkOut - more resources