Age Disparities in Mortality and ICU Utilization Following Suicide Attempts: Insights From the National Trauma Data Bank.

Abstract

Objective: This study aimed to identify factors associated with in-hospital mortality following suicide attempts and examine the disparities between methods used amongst older and younger cohorts.

Methods: A retrospective analysis of data from the National Trauma Data Bank was completed for the year 2022 for younger adults (18-54) and older adults (≥55) that presented to trauma centers following suicide attempts. The primary outcome was in-hospital mortality with secondary outcomes including any in-hospital complications as well as intensive care unit (ICU) and hospital length of stays.

Results: Older adults demonstrated higher in-hospital mortality compared to younger adults and differed in suicide methods, injury patterns, and clinical presentation. Older adults (40.7%) had a higher percentage of firearm use compared to younger adults (24.9%). Older adults were more frequently admitted to the intensive care unit compared to younger adults (44.5% vs 36.5%). In multivariable models, factors associated with increased mortality included, male sex, greater injury severity, lower GCS, head injury, and multiple comorbidities. Interaction analysis demonstrated that the effect of age on mortality differed by suicide method, with a greater age-related difference observed for jumping/lying-in-front injuries. In sensitivity analyses restricted to inpatients, the inverse association between ICU admission and mortality was attenuated.

Conclusion: Mortality following suicide attempts is influenced by both age and method, with older adults experiencing higher risk. The impact of early deaths on observed associations highlights the importance of incorporating timing of death in trauma-based analyses. These findings highlight age-related disparities and emphasize the need for tailored suicide prevention strategies.