ICU admission linked to increased risk of future suicide and
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Admission to an intensive care unit (ICU) is associated with a small increased risk of future suicide or self-harm after discharge compared with non-ICU hospital admissions, finds a study published in The BMJ.

The study analyzed the association between survival from critical illness and suicide or self-harm after hospital discharge.

Consecutive adult intensive care unit (ICU) survivors (?18 years) were included. Linked administrative databases were used to compare ICU hospital survivors with hospital survivors who never required ICU admission (non-ICU hospital survivors). Patients were categorized based on their index hospital admission (ICU or non-ICU) during the study period. 423060 consecutive ICU survivors were identified.

--During the study period, the crude incidence (per 100000 person-years) of suicide, self-harm, and the composite of suicide or self-harm among ICU survivors was 41.4, 327.9, and 361.0, respectively, compared with 16.8, 177.3, and 191.6 in non-ICU hospital survivors.

-- Analysis using weighted models showed that ICU survivors had a higher risk of suicide and self-harm.

--Among ICU survivors, several factors were associated with suicide or self-harm: previous depression or anxiety, previous post-traumatic stress disorder, invasive mechanical ventilation, and renal replacement therapy.

Conclusively, survivors of critical illness have an increased risk of suicide and self-harm, and these outcomes were associated with pre-existing psychiatric illness and receipt of invasive life support. Knowledge of these prognostic factors might allow for earlier intervention to potentially reduce this important public health problem.