Table 3.
Cox regression analyses identifying factors associated with suicide, self-harm, and suicide or self-harm among ICU survivors. Values are hazard ratios (95% confidence intervals)
| Factors | Suicide | Self-harm | Suicide or self-harm |
|---|---|---|---|
| Age (per one year) | 0.98 (0.98 to 0.99) | 0.96 (0.95 to 0.96) | 0.96 (0.96 to 0.96) |
| Female sex | 0.57 (0.49 to 0.67) | 1.00 (1.02 to 1.14) | 1.00 (0.95 to 1.06) |
| Neighbourhood income fifth | |||
| Lowest | Reference | Reference | Reference |
| Low | 1.13 (0.92 to 1.39) | 0.83 (0.75 to 0.87) | 0.83 (0.77 to 0.89) |
| Middle | 1.09 (0.87 to 1.35) | 0.78 (0.70 to 0.82) | 0.78 (0.73 to 0.84) |
| High | 0.92 (0.73 to 1.16) | 0.71 (0.63 to 0.74) | 0.71 (0.65 to 0.76) |
| Highest | 0.82 (0.64 to 1.05) | 0.67 (0.61 to 0.72) | 0.67 (0.62 to 0.73) |
| Urban residence | 0.92 (0.75 to 1.13) | 1.05 (0.99 to 1.15) | 1.05 (0.98 to 1.13) |
| Hospital length of stay (per one day) | 0.98 (0.97 to 0.99) | 0.99 (0.99 to 1.00) | 0.99 (0.99 to 1.00) |
| ICU length of stay (per one day) | 1.00 (1.00 to 1.01) | 1.00 (1.00 to 1.00) | 1.00 (1.00 to 1.00) |
| Charlson comorbidity index | |||
| ≤2 | Reference | Reference | Reference |
| 3-4 | 0.50 (0.36 to 0.70) | 0.73 (0.68 to 0.85) | 0.73 (0.65 to 0.81) |
| ≥5 | 1.07 (0.65 to 1.74) | 0.76 (0.55 to 0.88) | 0.76 (0.61 to 0.94) |
| Invasive mechanical ventilation | 1.50 (1.28 to 1.77) | 1.45 (1.37 to 1.53) | 1.45 (1.38 to 1.54) |
| Renal replacement therapy | 1.56 (1.05 to 2.32) | 1.35(1.16 to 1.56) | 1.35 (1.17 to 1.56) |
| Discharge disposition | |||
| Home without homecare | Reference | Reference | Reference |
| Home with homecare | 0.87 (0.71 to 1.08) | 0.82 (0.75 to 0.88) | 0.82 (0.76 to 0.88) |
| Continuing care or rehabilitation | 1.05 (0.75 to 1.48) | 0.79 (0.67 to 0.89) | 0.79 (0.70 to 0.91) |
| Long term care facility | —* | 0.29 (0.17 to 0.63) | 0.29 (0.15 to 0.57) |
| Psychiatric diagnoses† | |||
| Depression or anxiety | 5.73 (4.87 to 6.73) | 5.69 (5.38 to 6.05) | 5.69 (5.38 to 6.02) |
| Post-traumatic stress disorder | 1.50 (0.93 to 2.41) | 1.87 (1.67 to 2.19) | 1.87 (1.64 to 2.13) |
| Schizophrenia | 1.51 (1.16 to 1.96) | 1.39 (1.28 to 1.53) | 1.39 (1.28 to 1.52) |
| Bipolar affective disorder | 2.20 (1.70 to 2.84) | 2.38 (2.19 to 2.59) | 2.38 (2.20 to 2.58) |
| Hospital admissions in preceding year (per previous admission) | 0.88 (0.66 to 1.18) | 1.26 (1.20 to 1.31) | 1.25 (1.19 to 1.30) |
| Outpatient psychiatric visits in preceding year (per previous visit) | 1.02 (1.01 to 1.03) | 1.02 (1.02 to 1.02) | 1.02 (1.02 to 1.02) |
| Year of index hospital admission | |||
| 2009 | 0.57 (0.36 to 0.92) | 1.36 (1.12 to 1.65) | 1.25 (1.04 to 1.49) |
| 2010 | 0.54 (0.33 to 0.87) | 1.19 (0.98 to 1.45) | 1.10 (0.92 to 1.32) |
| 2011 | 0.53 (0.32 to 0.86) | 1.09 (0.89 to 1.32) | 1.02 (0.84 to 1.22) |
| 2012 | 0.68 (0.42 to 1.10) | 1.01 (0.82 to 1.23) | 0.96 (0.79 to 1.15) |
| 2013 | 0.57 (0.35 to 0.94) | 1.03 (0.84 to 1.26) | 0.97 (0.80 to 1.17) |
| 2014 | 0.75 (0.46 to 1.23) | 0.98 (0.79 to 1.20) | 0.94 (0.78 to 1.14) |
| 2015 | 0.63 (0.37 to 1.05) | 0.97 (0.79 to 1.20) | 0.93 (0.76 to 1.13) |
| 2016 | 0.91 (0.54 to 1.52) | 0.98 (0.79 to 1.22) | 0.96 (0.78 to 1.18) |
| 2017 | Reference | Reference | Reference |
ICU=intensive care unit.
*
Among patients who died by suicide, none were discharged to long term care.
†
Denotes diagnoses at index admission or previously.