Background: Suicide is the second leading cause of adolescent death and suicide
attempts outnumber deaths 50:1 for adolescents 15 to 19 years of age. This study examines
differences in outcomes between adolescents and adults treated at an adult trauma center in
an effort to guide recovery and prevention strategies following an adolescent suicide attempt.
Methods: Retrospective review of patients aged ≥14 years treated at an urban, Level 1
trauma center for self-inflicted injuries between 2009 and 2018 was performed. The cohort
was divided into adolescents (14-19 years) and adults (≥20 years) and into group A (economically
distressed) and group B (non-distressed). Demographics, injury, outcomes, and
geospatial analysis were compared.
Results: Among 723 patients, 60 (8%) were adolescents of which 92% were male, 55%
black, 47% blunt injuries, and 53% penetrating. In adults, 76% were male, 41% black, 28%
blunt injuries, and 72% penetrating. Mortality estimates for adolescents and adults were 35%
and 24%, respectively (p=0.09). Most adolescent deaths occurred within 3 days after admission,
while adult deaths occurred further into hospitalization (p<0.01). Cox regression analysis
found higher mortality with self-pay compared to private insurance (HR 2.6; p<0.001),
and penetrating vs. blunt/other injuries (HR 2.4; p<0.001). Psychiatric care was administered
in 64% of adolescents (n=39) and 84% of adults (p< 0.01).
Conclusion: Inpatient psychiatric care for adolescents who attempted suicide was limited at
an adult trauma center. The high incidence of suicide attempts and community-level distress
in adolescents require immediate attention and resources.