Objective: Suicide attempts remain a major public health concern
worldwide. This study aimed to analyze factors associated with inhospital
mortality and treatment Discontinuation Againts Medical
Advice (DAMA) following suicide attempts.
Methods: This retrospective, record-based, single-center observational
study included adult patients who presented to the emergency
department after a suicide attempt between January 2009 and December
2024. Data were obtained from the hospital information system,
medical records, and forensic notification files. Factors associated
with in-hospital mortality and DAMA were evaluated using logistic
regression analyses.
Results: A total of 2,909 individuals were included (mean age 30±12
years; 64.4% female). Drug ingestion was the most common suicide
method (84.2%). In-hospital mortality was observed in 2.2% of cases
(n=63), with the highest lethality rate (94.1%) among individuals who
attempted suicide by jumping from heights of five floors or higher.
In multivariable analysis, older age (OR: 1.04; 95% CI: 1.02–1.06),
male sex (OR: 4.40; 95% CI: 2.29–8.43), schizophrenia (OR: 3.63;
95% CI: 1.02–12.88), and alcohol use (OR: 2.38; 95% CI: 1.34–4.24)
were identified as independent predictors of in-hospital mortality.
Discontinuation against medical advice (DAMA) occurred in 53.8%
of cases (n=1,564) and was significantly associated with younger age,
absence of a prior suicide attempt, and fewer psychiatric comorbidities.
Conclusions: Suicide attempt aftercare should extend beyond acute
medical stabilization and incorporate proactive, individualized strategies
aimed at improving patient engagement and mitigating method-specific
risks.
Keywords: Discharge against medical