J Korean Med Sci.  2015 Oct;30(10):1466-1470. 10.3346/jkms.2015.30.10.1466.

Risk Factors of Discharged Against Medical Advice among Adolescents Self-inflicted Injury and Attempted Suicide in the Korean Emergency Department

• Jung JH
• Kim DK
• Jung JY
• Lee JH
• Kwak YH

• KMID: 2344180
• DOI: http://doi.org/10.3346/jkms.2015.30.10.1466

Abstract

Suicide is a leading cause of death among Korean adolescents. Many suicide attempting adolescents often are discharged against medical advice in the emergency department. The aim of the present study was to determine the risk factors for discharge against medical advice (DAMA) after self-inflicted injury or attempted suicide in the emergency department. We extracted data on adolescents (10-19 yr old) from the national emergency department information system; we used data from 2007 and 2011. A total of 6,394 adolescents visited EDs after self-inflicted injury or attempted suicide. Among these patients, the median age was 17 yr (Interquatile range, 15-18 yr), 83.2% were between 15-19 yr of age, and 63.3% were female. Poisoning was the most common method of attempted suicide, while hanging and fall were the most common methods of fatality. The rate of DAMA from the ED was 22.8%. Independent risk factors for DAMA included female gender (odds ratio [OR], 1.49), older age adolescents (OR, 1.96), residence in a metropolitan/large city area (OR, 1.49), and discharge at night (OR, 1.38). These risk factors should be considered in establishing management and counseling plans for patients discharged against medical advice by community services and EDs.

Keyword

Suicide, Attempted; Adolescent; Emergency Service, Hospital; Risk Factors; Patient Discharge

MeSH Terms

Adolescent
Adult
Child
Cross-Sectional Studies
Emergency Service, Hospital/utilization
Female
Humans
Male
Patient Discharge/*statistics & numerical data
Republic of Korea
Retrospective Studies
Risk Factors
Self-Injurious Behavior/*psychology
Suicide, Attempted/*psychology
Treatment Refusal/*psychology
Young Adult

Figure

• 

  Fig. 1 Flow diagram of study population. DAMA, discharge against medical advice.

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