• Michael Wallum, J Priyanka Vakkalanka, Sydney Krispin, and Daniel J McCabe.
• Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, United States of America.
• Am J Emerg Med. 2025 Feb 1; 88: 140144140-144.

ObjectivePrevious self-harm attempts are a known risk factor for subsequent suicide completion in adults but is unestablished among adolescents and young adults. Our objective was to determine the mortality rate for patients 10-24 years of age following discharge from the hospital after a non-lethal, intentional overdose.MethodsA retrospective cohort study was conducted of patients aged 10-24 years seen between 2017 and 2022 by the medical toxicology consultation service (MedTox) at a large tertiary care center who experienced a non-lethal, intentional overdose and survived this encounter. The National Death Index (NDI) was examined to determine whether any of these patients subsequently died. We characterized MedTox consultations by age, sex, and substances used. Among those who died, we descriptively characterized the patient's demographics, exposure, and clinical characteristics.ResultsThere were 1295 consultations for 1147 patients. Females accounted for 71 % of encounters, and most consults were for those aged 14-17 years (51 %), followed by those 18-21 years (25 %). Most commonly identified substances included acetaminophen (26 %), diphenhydramine (9 %), and ibuprofen (8 %). We identified 4 (<1 %) deaths identified from the NDI: two patients died by asphyxiation, one died by intentional overdose, and one died due to complications from chronic medical conditions.ConclusionOur observed mortality was lower compared to other studies (0.7 % - 13.3 %), which may have been due to protective factors (e.g., multidisciplinary evaluations) built into the institutional protocols at this center. Future studies will attempt to qualitatively and quantitatively identify individual- and system- level mechanisms in the pathway between self-harm and long-term health outcomes.Copyright © 2024 Elsevier Inc. All rights reserved.

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