• Ann Kutney-Lee, Gabriela K Khazanov, Joan G Carpenter, Hilary Griffin, Daniel Kinder, Scott T Shreve, Dawn Smith, Joshua M Thorpe, and Mary Ersek.
• Veteran Experience Center (A.K.L., J.G.C., H.G., D.K., D.S., J.M.T.,), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA; Center for Health Equity Research and Promotion (A.K.L., M.E.), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA; University of Pennsylvania School of Nursing (A.K.L., M.E.), Philadelphia, Pennsylvania, USA. Electronic address: ann.lee@va.gov.
• J Pain Symptom Manage. 2022 Aug 1; 64 (2): e63-e69.

ContextPalliative care consultations (PCCs) are associated with reduced physical and psychological symptoms that are related to suicide risk. Little is known, however, about the association between PCCs and death from suicide among patients at high risk of short-term mortality.ObjectiveTo examine the association between the number of PCCs and documentation of suicide in a cohort of Veterans at high risk of short-term mortality, before and after accounting for Veterans' sociodemographic characteristics and clinical conditions.MethodsAn observational cohort study was conducted using linked Veterans Affairs clinical and administrative databases for 580,620 decedents with high risk of one-year mortality. Logistic regression models were used to examine the association between number of PCCs and documentation of suicide.ResultsHigher percentages of Veterans who died by suicide were diagnosed with chronic pulmonary disease as well as mental health/substance use conditions compared with Veterans who died from other causes. In adjusted models, one PCC in the 90 days prior to death was significantly associated with a 71% decrease in the odds of suicide (OR = 0.29, 95% CI = 0.23-0.37, P < 0.001) and two or more PCCs were associated with a 78% decrease (OR = 0.22, 95% CI = 0.15-0.33, P < 0.001). Associated "number needed to be exposed" estimates suggest that 421 Veterans in this population would need to receive at least one PCC to prevent one suicide.ConclusionWhile acknowledging the importance of specialized mental health care in reducing suicide among high-risk patients, interventions delivered in the context of PCCs may also play a role.Published by Elsevier Inc.

12 keywords...

hide…