Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Decision-Making in Suicidal Attempt to Discharge from Emergency Department or to Consult Psychiatry: A Retrospective Study
İntihar Girişimlerinde Acil Servisten Taburcu Etme veya Psikiyatri Konsültasyonuna Yönelik Karar Verme: Retrospektif Bir Çalışma
Duygu EGEa, Kenan Ahmet TÜRKDOĞANb, Çağdaş Öykü MEMİŞc, Levent SEVİNÇOKc, Bilge DOĞANc
aDepartment of Emergency Medicine, Aydın Adnan Menderes University Practice and Research Hospital, Aydın, TURKIYE
bDepartment of Emergency Medicine, University of Health Sciences Bağcılar Training and Research Hospital, İstanbul, TURKIYE
cDepartment of Psychiatry, Aydın Adnan Menderes University Practice and Research Hospital, Aydın, TURKIYE
Turkiye Klinikleri J Med Sci. 2022;42(1):1-4
doi: 10.5336/medsci.2021-82287
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of this study is to shorten the period of hospitalization of the psychiatry patients in the emergency service and to reduce number of emergency psychiatric consultations. Material and Methods: Total 249 patients who admitted to the emergency service and evaluated by psychiatry because of suicide attempt were included in the study. The patients were scored in terms of feeling of regret, suicide method, history of previous suicidal attempt and presence of suicide family history. Following psychiatric consultations, the patients were divided to 2 groups as those who were considered for hospitalization (Group 1) and those who were recommended for outpatient psychiatry clinic control (Group 2). Results: Of the 249-psychiatry consultation, hospitalization was recommended to 94 (37.8%) patients, while outpatient psychiatry clinic control was recommended to 155 (62.2%). According to the scoring, it was found that psychiatric consultation was required in 152 (61.0%) patients, while consultation was not necessary in 97 (39.0%) patients. When psychiatric examination notes were checked, a statistically significant difference was found between Group 1 and 2 (p<0.001) and sensitivity was found to be 100%, while specificity was found as 62.5%, positive predictive value was found to be 61.8% and negative predictive value was found to be 100%. Conclusion: In our study group, we found that emergency psychiatric consultation rate may decrease 36.5% thus will be cost effective and also decrease waiting time in emergency services.

Keywords: Suicide; adult; emergency services, psychiatric
ÖZET
 Amaç: Bu çalışmanın amacı, psikiyatri hastalarının acil serviste yatış sürelerini kısaltmak ve acil psikiyatri konsültasyonlarının sayısını azaltmaktır. Gereç ve Yöntemler: Çalışmaya, acil servise başvuran ve psikiyatri tarafından intihar girişimi nedeniyle değerlendirilen 249 hasta dâhil edildi. Hastalar; pişmanlık hissi, intihar yöntemi, önceki intihar girişimi öyküsü ve ailede intihar öyküsü varlığı açısından puanlandı. Psikiyatri konsültasyonu sonucuna göre yatışı düşünülen hastalar (Grup 1) ve poliklinik kontrolü önerilen hastalar (Grup 2) olarak 2 gruba ayrıldı. Bulgular: İki yüz kırk dokuz psikiyatri konsültasyonundan 94'üne (%37,8) yatış, 155'ine (%62,2) poliklinik kontrolü önerildi. Uygulanan puanlamaya göre 152 (%61,0) hastada psikiyatri konsültasyonu gerektiği, 97 (%39,0) hastada konsültasyona gerek olmadığı belirlendi. Psikiyatrik muayene notlarına bakıldığında, 2 grup arasında istatistiksel olarak anlamlı farklılık (p<0,001) bulunmuş olup; duyarlılık %100, özgüllük %62,5, pozitif tahmin değeri %61,8 ve negatif tahmin değeri %100 olarak bulundu. Sonuç: Acil psikiyatri konsültasyonları %36,5 oranında azalabilir ve böylece hem maliyet azaltılabilir hem de acil servislerde bekleme süresi kısaltılabilir.

Anahtar Kelimeler: İntihar; erişkin; acil servisler, psikiyatrik
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