Ann Geriatr Med Res 2017; 21(4): 197-205  http://dx.doi.org/10.4235/agmr.2017.21.4.197
Predictive Value of Psychological Scales for Hospitalization of Elderly Suicide Attempters
Eundo Kim1, Ki Young Jeong2,3, Jong Seok Lee2,3, Han Sung Choi2,3
1Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Seoul, 2Department of Emergency Medicine, Kyung Hee University Medical Center, Seoul, 3Department of Emergency Medicine, Kyung Hee University School of Medicine, Seoul, Korea
Correspondence to: Ki Young Jeong, MD, PhD
Department of Emergency Medicine, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
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Received: September 25, 2017; Revised: October 23, 2017; Accepted: October 25, 2017; Published online: December 31, 2017.
© The Korea Geriatrics Society. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Suicide lethality and intent are known potential determinants of hospitalization, and high degrees of these factors are discriminating characteristics of elderly suicide attempters. We evaluated their ability to predict hospitalization in elderly suicide attempters.
Methods: Via medical charts and interview questionnaires, data were collected retrospectively on suicide attempters aged 65 years and older who presented to the Emergency Department (ED) from January 2012 to December 2016. Subjects were divided into hospitalization and discharge groups. Degrees of suicide lethality and intent were evaluated using the Risk-Rescue Rating Scale (RRRS) and the Suicide Intent Scale (SIS), respectively. The predictive abilities of these scales for hospitalization were assessed using logistic regression analysis and compared with the area under the receiver operating characteristic curve.
Results: Of 168 patients, 110 (65%) were hospitalized. The RRRS and SIS scores for hospitalized patients were significantly higher; both scales were identified as independent predictors of hospitalization. The predictive performance of the RRRS for hospitalization was significantly superior to that of the SIS. Among SIS subscales, only the SIS part 2 was found to be an independent predictor of hospitalization. Its performance tended to be higher than the SIS, and comparable to the RRRS. The RRRS and SIS part 2 had greater sensitivity for predicting hospitalization than specificity.
Conclusion: For elderly suicide attempters in the ED, the RRRS is a useful predictor of hospitalization. Further investigations based on the feasibility of the SIS part 2 as a predictor are needed.
Keywords: Elderly, Suicide, Scales, Hospitalization, Emergency Department


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