Intento de suicidio vía ingesta de fármacos en niños

Abstract

Suicide attempts in children are an important worldwide cause of morbidity and mortality and an emerging reason for admission in Pediatric Critical Care. Objective: Identify the epidemiologic and clinical characteristics of patients with drug poisoning with a suicide purpose as an admission cause in a Chilean Pediatric Intensive Care Unit (PICU). Design: Retrospective observational study. Setting: 14 beds PICU of a tertiary care public teaching hospital in Santiago de Chile. Material and Method: All patients admitted to the PICU between January 2005 and December 2008 for self-inflicted drug poisoning with an expressed intention of suicide were included. Analysis of the PICU clinical chart was performed with sampling on an excel data base. For seasonal distribution we used statistical analysis Xi2. Results: 178 of 3045 PICU admissions were diagnosed as drug poisoning (5,8%), 108 of them for suicide attempts (60,6 %).The number of annual patients increased, with highest incidence in spring and autumn and lowest in winter. Mean and median age was 13 years, 8,4% less than 12 years. 88,9% were females. They used polipharmacy in 57%. Drugs were taken from home. Antidepressants and sedatives were the most often used. An underlying psychiatric condition was present in 100 cases (92,6%). Associated factors were family disfunction, school problems, abuse and violation and bullying. Mean PICU stay was 1,46 days with 16,7 % requiring transient mechanical ventilation No death was reported in this serie. Conclusions: The number of cases of suicide attempt via drug ingestion as a motive for admission in PICU is increasing, causing a raising number of short and transient admissions, more in spring less in winter. Risk factors were mostly an underlying psychiatric disorder and family disfunction.