Citation

Chevallard G, Veronese G, Giudici R, Pressato L, Pozzi F, Compagnone C, Fossi F, Bernasconi F, Curto F, Zaniboni M, Bassi G, Chiara O, Fumagalli R, Chieregato A. Minerva Anestesiol. 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Edizioni Minerva Medica)

DOI

10.23736/S0375-9393.20.14970-8

PMID

33174409

Abstract

The government of Italy imposed a lockdown with a stay-at-home order from March 8 to May 4 in response to the growing spread of coronavirus disease 2019 (COVID-19) pandemic in the country. Concerns regarding the mental health effects of COVID-19 pandemic have been raised with the attention focused towards suicide risk [1,2]. We report the number of trauma due to suicide attempts admitted to the Intensive Care Units (ICUs) of Niguarda hospital in Milan which served as the largest trauma center in Lombardy in the prepandemic era and during the quarantine in accordance to dispositions settled by the Regional Health Government [3,4]. Changes to the local ICU utilization were accomplished: a 76-bed ICU for COVID-19 patients and a 20-bed ICU for non-COVID-19 patients were instituted. Of note, the precrisis total ICU capacity of Niguarda hospital was 35 beds. Overall, during the lockdown period, 169 patients were consecutively admitted to the 20-bed ICU for non-COVID-19 patients, of whom 50 (29.6%) were trauma cases. No trauma admissions were recorded in the ICU for COVID-19 patients. Suicide attempt was recorded in one third of trauma patients (n=15, 30.0%), with self-defenestration from a great height being the most common injury mechanism (60.0%). Median age was 62 years old with a male prevalence of 66.6%. Of note, all suicide patients were affected by mental disorders diagnosed before admission, with the majority suffering from schizophrenia or schizophrenia-like psychoses and depression. Their ICU mortality was 13.3%. The absolute number of attempted suicides admitted to the ICUs of Niguarda hospital in the same time period in 2018 and 2019 was 6 and 4, respectively (approximately 10% of all trauma cases). These findings may be affected by confounders which can potentially limit the effort to prove, if any, the causal association between the lockdown and the observed increased number of attempted suicides. The exceptional reorganization of regional health during the pandemic and the role of Niguarda hospital as major regional hub for trauma may have played a role in determining the reported high absolute number of ICU admission for suicide attempts. The reduction of road accidents due to lockdown mobility restrictions may have as well influenced proportions. However, despite the efforts, we proved the absence of a reliable source providing data on suicide attempts, i.e. we investigated two institutional regional databases where the reported rates of suicide attempts/committed suicides were clearly underestimated, vanishing the chance to have a broader validation of our findings. We thus,...

Language: en