The research on suicide attempts of the patients 50 years old and over who admitted to the emergency medicine department between 2010-2020

In this study, the patients who applied to Dicle University Faculty of Medicine Emergency Medicine Clinic by using chemical substances in suicide attempt; It was aimed to investigate the types of poisoning, the factors affecting mortality and the differences between genders. After the approval of ethics comitee, our study was conducted with 72 patients over the age of 50 who applied into the Dicle Univesity Faculty of Medicine Emergency Clinic with a suicide attemp between January 1, 2010 and September 31, 2020. The patients were screened retrospectively by their demograpohic characteristics (age, gender, season), their vital signs (blood pressure, mean arterial blood pressure, pulse, saturation) electrocardiographic features, chronic illnesses, trauma score (Glasgow coma scale: GCS), group of drugs used, blood gas values (pH, lactate and HCO3), hemogram values (hemoglobin, leukocyte, platelet levels), coagulation values (APTT, PT, INR levels), active carbon and lavage application, treatment methods, mechanic ventilator needs, follow-up status and outcomes were analzyed. The variables were conducted for normality test by using Kolmogorov-Smirnow test. The data that were normal were stated as mean value ± standart deviation, and the categorical data that weren't normal were stated as n (%). To analyze the constant variables, Student-t test was used. Categorical differences were compared by using Chi-Square test. In all of the parameters, p<0,05 is stated as significant. Thirty-five (%48,6) of the patiens were female while 37 (%51,4) of them were male. It is stated that male-female ratio was 1,05/1. Average age of patients was 63.0 ± 9,84 years. There seemed to be no difference in average age between men and women (p>0,05). In terms of age and gender, no difference was found between the deceased and survivors. The majority of the patients were in the group between 50-59 years of age, while the least patients were in the group over 80 years old. Most of the applications were detected in the spring season. No difference were found between genders in terms of seasons. No significant difference was found in the effect of seasons on mortality (p> 0,05). No difference was found between genders based on the presence of additional disease (comorbidity) (p> 0,05). The number of patients with cardiovascular problems and psychiatric problems was observed to be higher. No relation between the initial blood pressure and mortality were found. No difference was found between the genders in terms of drug choice (p> 0,05). It was found that agro-pesticides were most frequently used. It was detected that men were mostly monitered in intensive care unit. No difference were found in male and female in terms of mortality (p> 0,05). It was observed that MAP, bradycardia-tachycardia-normal rhythm and oxygen saturation did not affect mortality. It was found that there was a difference between the dead and the survivors in terms of pH, lactate, HCO3, WBC, and INR values. Having a GCS score below 15 was found to affect mortality (p> 0,05). No relation between the initial blood pressure and mortality were found. pH below 7.35 was observed to have an affect on mortality (p> 0,05). Lactate value below 2 mmol/l was found to affected survival and above 4 mmol/L affected mortality (p> 0,05). It was found that the HCO3 value below 22 mmol/l had an affect on mortality (p<0.05). The presence of leukocytosis was seen to affect mortality (p<0.05). It was found that the INR value above 1.2 increased mortality(p<0.05). No difference in mortality was found between deceased and survivors using mechanical ventilators (p>0.05). It was detected that there was no difference in outcome between those who died and those who survived with intensive care follow-up (p>0.05). In conclusion, we are of the opinion that appropriate treatment to reduce the number of cases and mortality of advanced adult and geriatric patients admitted to emergency departments as a result of suicide attempts, organizing the team that manages the case by experienced people, such as an emergency medicine specialist, for situations that we have found increase mortality, psychotherapy and social support should be provided.