title: Emergency Department Visits Prior to Suicide and Homicide: Linking Statewide Surveillance Systems.
abstract: BACKGROUND
  Emergency departments (EDs) serve a wide range of patients who present at risk of impending suicide and homicide.
  
  
  OBJECTIVE
  Two statewide surveillance systems were probabilistically linked to understand who utilizes EDs and then dies violently within 6 weeks.
  
  
  METHODS
  Each identified case was matched with four randomly selected controls on sex, race, date of birth, resident zip code, and date of ED visit vs. date of death. Matched-pair odds ratios were estimated by conditional logistic regression to assess differences between cases and controls on reported diagnoses and expected payment sources.
  
  
  RESULTS
  Of 1,599 suicides and 569 homicides in the 3-year study period, 10.7% of decedents who died by suicide (mean = 13.6 days) and 8.3% who died by homicide (mean = 16.3 days) were seen in a state ED within 6 weeks prior to death. ED attendees who died by suicide were more likely to have a diagnosis of injury/ poisoning diagnosis or mental disorder and more likely to have Medicare. Those who died by homicide were more likely to have a diagnosis of injury/poisoning and less likely to have commercial insurance.
  
  
  CONCLUSIONS
  It is essential for research to further explore risk factors for imminent suicide and homicide in ED patients who present for psychiatric conditions and general injuries.
authors.affiliation: 1 University of Kentucky, College of Social Work, Lexington, KY, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Cerel
authors.affiliation: 2 University of Kentucky, Department of Biostatistics and the Kentucky Injury Prevention and Research Center, Lexington, KY, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Singleton
authors.affiliation: 3 University of Kentucky, Department of Epidemiology and Kentucky Injury Prevention and Research Center, College of Public Health, Lexington, KY, USA.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Brown
authors.affiliation: 3 University of Kentucky, Department of Epidemiology and Kentucky Injury Prevention and Research Center, College of Public Health, Lexington, KY, USA.
authors.forename: Sabrina V
authors.initials: SV
authors.lastname: Brown
authors.affiliation: 4 University of Kentucky, Department of Biostatistics, Lexington, KY, USA.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Bush
authors.affiliation: 5 University of Kentucky , Department of Statistics/DATAQUeST, Lexington, KY, USA.
authors.forename: Candice J
authors.initials: CJ
authors.lastname: Brancado
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D062665:Epidemiological Monitoring; D005260:Female; D006708:Homicide / Q000517:prevention & control / Q000706:statistics & numerical data*; D006801:Humans; D016247:Information Storage and Retrieval; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000453:epidemiology*; D016017:Odds Ratio; D011041:Poisoning / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult; D000092864:Suicide Prevention
keywords: emergency; homicide; linkage; suicide; violent deaths