ScholarWorks@중앙대학교

초록

Background: Suicide remains a significant public health issue in South Korea. While survival following a suicide attempt may depend not only on physical treatment but also on the adequacy of mental health interventions, most existing studies have focused on patients visiting emergency departments. There is a paucity of empirical research analyzing mortality among suicide attempters who received inpatient care, especially studies that distinguish survivors and decedents using the underlying cause of death. Objectives: This study aimed to identify factors associated with suicide-related mortality by comparing the characteristics of survivors and decedents among hospitalized patients after a suicide attempt, thereby providing evidence for early intervention and hospital-based prevention strategies targeting high-risk groups. Methods: A cross-sectional study was conducted using the 15th–18th Korea National Hospital Discharge In-depth Injury Survey (2019–2022). Among 73,728 patients hospitalized for intentional self-harm, 3,376 who died from suicide (coded X60–X84 in KCD-8th) and 70,352 survivors were included in the final analysis. Chi-square tests and multivariable logistic regression were performed to examine the associations between mortality and five categories of variables: sociodemographic, health behavior and clinical, healthcare utilization, suicide-related behaviors, and environmental factors. Results: Several significant risk factors for suicide mortality were identified. Older adults had substantially higher risk, with those aged 70 and above showing a 10.34-fold increase compared to those aged 10–29 (p<0.001). Non-metropolitan residence (OR=2.09), absence of psychiatric diagnosis (OR=3.94), and higher Charlson Comorbidity Index (CCI ≥2; OR=5.71) were associated with increased risk. Emergency admissions posed greater risk than outpatient routes (OR=1.31), whereas longer hospital stays (≥8 days) were associated with lower risk (OR=0.17). Among behavioral factors, asphyxiation as a suicide method presented the highest risk (OR=76.66), and suicide motivated by bereavement (OR=2.48) also showed elevated risk. Attempts at home were associated with lower mortality (OR=0.81), while attempts within medical facilities showed the highest fatality rate (14.0%). Conclusions: This study highlights key risk factors for suicide-related mortality among hospitalized attempters, including older age, absence of psychiatric diagnosis, comorbid physical illness, regional disparities, and use of lethal methods. These findings underscore the need for multidisciplinary and continuous mental health interventions within hospital systems and the importance of integrating suicide prevention protocols beyond psychiatry into general medical practice.

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