The risks for suicide and self-harm are increased for survivors of critical illness, according to a study published in BMJ. Investigators examined the correlation between survival from critical illness and suicide or self-harm after discharge in a population-based cohort study. Adult ICU hospital survivors were compared with hospital survivors who never required ICU admission using linked administrative databases. Data were included for 423,060 consecutive ICU survivors (mean age, 61.7 years). The crude incidence rates of suicide, self-harm, and the composite of suicide or self-harm were 41.4, 327.9, and 361.0, respectively, per 100,000 person-years among ICU survivors, compared with 16.8, 177.3, and 191.6, respectively, in non-ICU hospital survivors. Compared with non-ICU hospital survivors, ICU survivors had higher risks for suicide and self-harm using weighted models (adjusted hazard ratios [aHRs], 1.22 and 1.15, respectively). Factors associated with suicide or self-harm among ICU survivors included previous depression or anxiety, previous PTSD, invasive mechanical ventilation, and renal replacement therapy (HRs, 5.69, 1.87, 1.45, and 1.35, respectively). “Patients and their loved ones shouldn’t be afraid if they need life-saving care in the ICU, as the rates of suicide we found are still very low,” a coauthor said in a statement. “Our main message to patients is that it’s okay to not be okay after an ICU admission, and, as physicians, we’re becoming more aware of this.”

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