Patient and Clinical Characteristics Associated With Subsequent Suicide Attempt Among Youth in the Emergency Department With a Positive Suicide Risk Screen.

STUDY OBJECTIVE: To evaluate sociodemographic and clinical characteristics associated with a subsequent suicide attempt among youth with a positive suicide risk screen in the emergency department (ED). METHODS: This secondary data analysis used the 2015 to 2019 Pediatric Emergency Care Applied Research Network ED Screen for Teens at Risk for Suicide data set, a prospective cohort of adolescents aged 12 to 17 years in the ED. Adolescents with positive Ask Suicide-Screening Questions, a validated suicide risk screen, were included. Multivariable regression models assessed sociodemographic and clinical characteristics associated with suicide attempt, and mental health-related ED revisit/hospitalization, within 3 months after index ED visit. RESULTS: Among 2,085 adolescents with a positive Ask Suicide-Screening Questions (40.7% age 14 to 15 years; 65.5% female, 49.0% Non-Hispanic White), 11.6% attempted suicide and 19.9% had an ED revisit/hospitalization within 3 months. Risk factors of suicide attempt included suicide attempt in the past month (adjusted odds ratio [aOR] 2.52, 95% confidence interval [CI] 1.84 to 3.45), prior mental health hospitalization (aOR 1.39, 95% CI 1.02 to 1.90), past nonsuicidal self-injury (aOR 2.06, 95% CI 1.41 to 3.01), and hopelessness (aOR 1.30, 95% CI 1.04 to 1.63). Risk factors of ED revisit/hospitalization within 3 months included prior mental health hospitalization (aOR 2.23, 95% CI 1.74 to 2.84), suicide attempt in the past month (aOR 1.63, 95% CI 1.24 to 2.14), and hopelessness (aOR 1.44, 95% CI 1.21 to 1.72). CONCLUSION: Among youth with positive suicide risk screens in the ED, multiple sociodemographic and clinical factors were associated with subsequent suicide attempt and mental health-related ED revisits/hospitalizations. Following a positive suicide risk screen, these factors may be important for consideration when assessing risk and determining next steps in care.