Meta‐analysis of suicide rates among people discharged from non‐psychiatric settings after presentation with suicidal thoughts or behaviours

摘要

Objective To quantify the suicide rate among people discharged from non‐psychiatric settings after presentations with suicidal thoughts or behaviours. Method Meta‐analysis of studies reporting suicide deaths among people with suicidal thoughts or behaviours after discharge from emergency departments or the medical or surgical wards of general hospitals. Results A total of 115 studies reported 167 cohorts and 3747 suicide deaths among 248?005 patients during 1?263?727 person‐years. The pooled suicide rate postdischarge was 483 suicide deaths per 100?000 person‐years (95% confidence interval ( CI ) 445–520, prediction interval ( PI ) 200–770) with high between‐sample heterogeneity ( I 2 ?=?92). The suicide rate was highest in the first year postdischarge (851 per 100?000 person‐years) but remained elevated in the long term. Suicide rates were elevated among samples of men (716 per 100?000 person‐years) and older people (799 per 100?000 person‐years) but were lower in samples of younger people (107 per 100?000 person‐years) and among studies published between 2010 and 2018 (329 per 100?000 person‐years). Conclusions People with suicidal thoughts or behaviours who are discharged from non‐psychiatric settings have highly elevated rates of suicide despite a clinically meaningful decline in these suicide rates in recent decades.