517 - Suicide-Related ED Encounters and Hospital Admissions Among Adolescents from 2015 – 2021 in Dallas, Texas.

The COVID-19 pandemic led to an increase in mental health concerns among adolescents. In Texas, evaluation of suicide-related Emergency Department (ED) encounters and hospital inpatient admissions over time is important to assess the mental health needs within certain populations and regions.

Objective:

We described trends of adolescent suicide-related ED encounters and inpatient admissions from 2015–2021.

Design/Methods:

We conducted a cross-sectional, electronic health record (EHR) query to identify suicide-related diagnosis codes starting five years (2015–2019) prior to the COVID-19 pandemic and two years (2020–2021) during the pandemic at a large, urban, free-standing, academic children’s hospital in North Texas. Patients aged 10–21 years with suicide-related International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes evaluated in the ED or admitted to the inpatient setting were examined by year. In our analysis, the ED group consisted of both ED and observation patient classes. Given that ED and inpatient admissions may have been disrupted by the pandemic, we calculated the number of annual suicide-related encounters as a proportion of the total number of encounters each year. As a nonpsychiatric comparator, we also examined the trend for ED-associated appendicitis codes each year among the total number of ED encounters for the same age.

Results:

Overall, from 1/1/2015 through 12/31/2021 among 10–21 year-olds, there were a total of 259,656 ED encounters of which 11,440 had suicide-related diagnoses (4.4% of total ED visits). Among 36,515 inpatient admissions, 2,990 had suicide-related diagnoses (8.2% of total inpatient admissions). In terms of the annual percent of suicide-related diagnoses among all ED encounters, there was a positive increase over time: 2.0% in 2015, 2.5% in 2016, 3.0% in 2017, 4.1% in 2018, 4.5% in 2019, 7.1% in 2020, and 8.1% in 2021. For inpatient admissions, the percent of suicide-related diagnoses also grew over time: 5.1%, 4.7%, 7.0%, 9.1%, 9.5%, 12.1%, and 10.1% from 2015–2021 respectfully. In terms of appendicitis diagnoses in the ED, the annual percent over the 7 years remained constant at 1% – 2% each year.

Conclusion(s): Suicide-related diagnoses have increased over the past seven years, with an obvious rise since the pandemic for the ED and inpatient setting despite historic diagnoses (appendicitis) staying constant. More data in later years and other locations in Texas are needed to evaluate disparities and target interventions to highest-risk populations.