Fatores associados às vítimas de tentativas de suicídio atendidas em um serviço hospitalar de urgência e emergência

Abstract

Introduction: Every year 800,000 people die from suicide worldwide, mainly between 15 and 29 years old. Considered a public health problem, suicide rates mainly affect developing countries, causing long-term suffering in many families, communities and countries (Pan American Health Organization, 2018). It is estimated that suicide attempts are at least 10 times greater than the reported data (LIOTTA; MENTO; SETTINERI, 2015). During the care of patients who are victims of suicide attempts, it is usual for them to receive and make use of care according to protocols and that include medical, toxicological and psychological evaluation, in services where these supports exist (CALEGARO, 2018). Prevention programs have been launched to raise awareness of society, highlighting the Yellow September campaign, created by the Centro de Valorização da Vida (CVV) in partnership with the Federal Council of Medicine (CFM) and the Brazilian Association of Psychiatry (ABP). In line with the WHO recommendation for prevention, intervention and monitoring of populations at risk (COSTA, et al., 2018; RIOS FILHO, 2016; WORLD HEALTH ORGANIZATION, 2019). This research seeks to trace the sociodemographic, clinical profile and factors associated with victims of attempted suicide, which are important data to support the organization of the service, new public policies, prevention programs and incentives for new research. Objective: to analyze the factors associated with victims of attempted suicide treated by the hospital urgent and emergency service and monitor the outcome in relation to survival or death. Method: Observational, longitudinal, retrospective study, with a quantitative methodological approach. Data collection took place from medical records at the Medical Archive Service (SAME), attended in the urgency and emergency sector Adult Emergency Room (PS-A) of a Public Teaching Hospital in Triângulo Mineiro, between the years 2013 to 2020 , aged 14 years or older. The information was recorded in a data collection instrument developed by the author together with her advisor and was submitted to evaluation by specialists on the subject regarding the form and content for better identification of the research variables, identification and ordering. The APACHE II scale was also applied with data from the first 24 hours of hospitalization. A pilot test was carried out with 15 medical records, in order to test the instrument. Data analysis was carried out through simple descriptive statistical analysis, measures of centrality (mean and median) and variability (amplitude and standard deviation). The bivariate analysis considered measures of association Chi-Square test, relative risk and odds ratio. The simultaneous influence of clinical sociodemographic variables and type of selfviolence on survival included logistic regression analysis. This work considered a significance level of 5%. The APACHE II scores were calculated using variables measured based on the patient's condition within the first 24 hours after the suicide attempt in order to measure its severity and distinguish patients with the potential for survival or death. Results: Of a total of 191 patients, the victims of attempted suicide were mostly men, adults, white, without a partner, students, with mental comorbidities, using some medication at home, the most prevalent mechanism of self-violence being drug abuse. Regarding the event, the day of the event was highlighted: Friday, the victims arrived at the hospital service referred by SAMU/USA. The vast majority had no previous attempts, survived the event and were referred after hospital discharge to specialized services. Death was related to a high final score of the APACHE II instrument. Conclusion: Suicide happens due to a behavioral act, including complex, universal 11 and multifactorial issues, and its risk factors are population and/or individual (KIELAN et al., 2018; SINYOR et al., 2017). Further research on this topic is necessary for a better understanding of the care provided to victims of suicide attempts in urgent and emergency services, in addition to a differentiated look by government agencies and carrying out campaigns that promote mental health and the well-being of the population. of this study.