Alcohol-Related Emergency Admissions: A Marker for Suicide Risk

Alcohol use disorders figure prominently among risk factors for suicide. In the U.K., prevalence of suicide is estimated at 7% in alcohol-dependent individuals, 10 times greater than in the general population. To ascertain whether emergency hospital admissions for alcohol-related diagnoses might indicate an increased risk and need for preventive intervention, investigators analyzed various databases on 2.8 million individuals in Wales.

The researchers examined emergency hospital admissions for a full spectrum of alcohol-related conditions — mental and behavioral disorders, toxic effects and poisonings owing to alcohol, and other (gastroenterological and other alcohol-related medical diseases; encounters with alcohol services). During a 6-year follow-up, 1437 people without alcohol-related emergency hospitalizations and 125 with such hospitalizations died by suicide, with 9% occurring within 4 weeks of discharge. In adjusted analyses, suicide risk in the emergency admissions group was 15.6 times higher than in the general population. Risk was highest for those hospitalized for toxic effects or alcohol poisoning. Suicide rates were >3 times higher for men than women in the general population but were higher for women than men in the alcohol-related hospitalization group. Compared with women in the general population, women with hospitalizations and psychiatric comorbidity had an adjusted hazard ratio of 44 for suicide (AHR in men, 21); in women with hospitalizations and no psychiatric diagnosis, the AHR was 24 (AHR in men, 8).