Characteristics and lethality of suicide attempters by age group in Korea: Retrospective single-centered study

Background: Suicide is a major cause of death worldwide. While studies have been conducted on the predictors of suicide behaviors, these have not covered how lethality and the various predictors differ by age. We explored these age differences in the present study. Methods: We retrospectively reviewed the medical records of suicidal patients in the emergency department (ED) of a university hospital in Seoul, South Korea, between September 2017 and August 2018. We extracted participants' data from the National Emergency Department Information System of Korea and their individual electronic medical records (EMRs), including demographic information (e.g., age, gender), details of their ED visit (e.g., suicide method), and medical history (e.g., physical illness, alcohol co-ingestion). We also used EMR data to complete the Risk-Rescue Rating Scale (RRRS). Results: Of the 499 patients referred to the ED for suicide attempts, 427 were analyzed. We found that while younger participants were more likely to have repeated attempts, older participants' attempts were more likely to be fatal (e.g., higher RRRS risk scores and lower accessibility-to-rescue scores). After adjusting for demographics, older participants showed significantly higher scores on RRRS risk, impaired consciousness, and treatment required than younger participants. Conclusion: Our findings clarified the characteristics of high-risk suicide attempters based onage, which could influence suicide-prevention policies (e.g., younger people tend to repeat suicide attempts, and thus may require continued surveillance). However, as older adults showed higher lethality and were more difficult to save, they may require suicide prevention coupled with social support interventions.