title: Scale for assessment of lethality of suicide attempt.
abstract: BACKGROUND
  Lethality of suicidal attempt provides useful information regarding the behavior. There is a perceived need for a clinically useful scale that can be easily adapted to various methods and circumstances of attempt.
  
  
  OBJECTIVE
  The study intended to develop and test utility of a scale for measuring lethality that can reflect overall clinical observation taking into account various indicators of lethality and which can be used across clinical scenarios involving different methods.
  
  
  METHODS
  Cross-sectional study in a hospital.
  
  
  METHODS
  The scale for assessment of lethality of suicide attempt (SALSA) has two components: The first component has four items indicating seriousness of the attempt and its likely consequences and the second component is the global impression of lethality. All the items are scored from 1 to 5, higher scores suggestive of increased lethality. SALSA was used to evaluate lethality of 82 consecutive suicide attempters; and it was compared with lethality of suicide attempt rating scale (LSARS) and risk-rescue rating scale.
  
  
  METHODS
  Chi-square, t-test, analysis of variance, Cronbach's alpha, binary logistic regression.
  
  
  RESULTS
  There was significant correlation of SALSA score with that of LSARS (r: 0.89) and risk score of risk-rescue rating (r: 0.93, P < 0.001); and negative correlation with rescue score (r: -0.569; P < 0.001). Internal consistency reliability of SALSA was high (Cronbach's alpha: 0.94). Lethality scores of SALSA differentiated known groups with different lethality, e.g. deceased and survived; attempters with different levels of medical intervention: In-patient only, intensive care, ventilator support. SALSA score significantly predicted the lethal outcome (odds ratio: 3.2, confidence interval: 1.12-8.98).
  
  
  CONCLUSIONS
  SALSA is a useful instrument for assessment of lethality of suicidal behaviors during clinical evaluations considering the ease of administration, its ability to differentiate clinical groups with known variations of lethality and clinical outcomes.
authors.affiliation: Department of Psychiatry, Black Country Partnership NHS Foundation Trust, Wolverhampton, United Kingdom.
authors.forename: Nilamadhab
authors.initials: N
authors.lastname: Kar
authors.affiliation: Department of Forensic Medicine and Toxicology, JSS Medical College, Mysore, India ; Department of Forensic Medicine and Toxicology, Kasturba Medical College, Manipal, Karnataka, India.
authors.forename: Mohanram
authors.initials: M
authors.lastname: Arun
authors.affiliation: Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
authors.forename: Manoj K
authors.initials: MK
authors.lastname: Mohanty
authors.affiliation: SBKS Medical Institute and Research Centre, Vadodara, Gujarat, India.
authors.forename: Binaya K
authors.initials: BK
authors.lastname: Bastia
keywords: Attempted suicide; lethality; reliability; scale; suicide; validity