A0464 - Prevalence and Trends in Hospitalizations for Suicidal Ideation, Suicide, and Self-Inflicted Harm Among Patients With Cirrhosis: A Nationwide Analysis

Ayooluwatomiwa D. Adekunle, MD, MPH¹, Mary Sedarous, MD², Abimbola O. Ajibowo, MD³, Oyedotun I. Babajide, MD⁴, Chinelo J. Eruchalu, ⁵, Tahniyat Tariq, BSc⁶, Philip N. Okafor, MD, MPH^7
1St. Luke's Hospital, Chesterfield, MO; ²McMaster University, Hamilton, ON, Canada; ³Lugansk State Medical University, Dallas, TX; ⁴One Brooklyn Health- Interfaith Medical Center, Brooklyn, NY; ⁵University of Central Florida, Orlando, FL; ⁶Stanford University School of Medicine, Redwood City, CA; ⁷Mayo Clinic, Jacksonville, FL

Introduction: Chronic illnesses have been associated with suicidal ideation (SI), suicide and self-inflicted harm (S/SIH). However, suicidality in patients with cirrhosis is understudied. We sought to describe trends, predictors, and outcomes of SI and S/SIH among hospitalized patients with cirrhosis, using a nationally representative dataset.

Methods: Using the 2007-2014 Nationwide Inpatient Sample, we determined trends in cirrhosis-related SI and S/SIH hospitalizations. We compared baseline characteristics between patients with cirrhosis hospitalized with SI and S/SIH vs. those without suicidality. Multivariable regression analysis was used to identify patient-level predictors of SI and S/SIH. We also compared outcomes including all-cause inpatient mortality, hospital length of stay (LOS), and costs

Results: Suicidal ideation and S/SIH-related hospitalizations accounted for 1.2% of all cirrhosis admissions. Hospitalizations for SI increased steadily while those for S/SIH decreased after peaking in 2010 (Figure 1). The majority of SI and S/SIH hospitalizations occurred in men, Medicaid patients, and among individuals with depression and anxiety [Table 1]. On multivariable analysis, older age (adjusted odds ratio [aOR] 0.12, 95% Confidence Interval [C.I.] 0.1-0.13), female sex (aOR =0.77, 95%CI= 0.78-0.81), and private payer status (aOR =0.58, 95%CI= 0.54-0.63) were associated with lower odds of SI and S/SIH. Blacks (aOR=0.55, 95%CI=0.5-0.6) and Hispanics (OR=0.63, 95%CI= 0.57-0.7) had significantly lower odds of suicidality compared to White patients. While patients from lower ecological socioeconomic groups, those on Medicaid (aOR=1.21, 95%CI=1.13-1.29), and those with comorbid depression (aOR=1.63, 95%CI=1.52-1.75) and anxiety (aOR=2.58, 95%CI=2.41-2.76) had higher adjusted odds of suicidality. All-cause inpatient mortality was lowest among patients with SI (0.6%) compared to those with S/SIH (2.7%). In addition, patients with SI had longer LOS than those without SI (6.7 vs 6.0 days, p=0.012). Hospital costs were also significantly lower for those with SI ($8270) compared to those with S/SIH ($12376) [Table 1].

Discussion: In this nationally representative cohort, we observed a rising trend in suicidal ideation among patients with cirrhosis especially patients who were younger, White, from lower socioeconomic backgrounds, with comorbid anxiety and depression. Hospitalizations for suicide and self-inflicted harm appeared to be on the downtrend.




Disclosures:


Ayooluwatomiwa D. Adekunle, MD, MPH¹, Mary Sedarous, MD², Abimbola O. Ajibowo, MD³, Oyedotun I. Babajide, MD⁴, Chinelo J. Eruchalu, ⁵, Tahniyat Tariq, BSc⁶, Philip N. Okafor, MD, MPH⁷. A0464 - Prevalence and Trends in Hospitalizations for Suicidal Ideation, Suicide, and Self-Inflicted Harm Among Patients With Cirrhosis: A Nationwide Analysis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.