Risk Factors for Suicide Following Hospital Discharge Among Cancer Patients

Objectives: This study aims to examine risk factors associated with 3-month post-discharge suicide among cancer patients using Taiwan's nationwide, population-based datasets.

Methods: The study cohort comprised all cancer patients discharged from hospitals from 2002 to 2004, inclusive, who committed suicide within 90 days of discharge (n=311). The control group consisted of 1555 cancer patients who did not commit suicide within 90 days of discharge. The dependent variable was whether or not a patient committed suicide within 90 days of discharge, while the independent variables included patient, hospital and physician characteristics at index hospitalization. Cox proportional hazard regression was carried out to compute the 90-day survival rate, adjusting for possible confounding factors.

Results: The mean interval from discharge to suicide was 39.7 days (+/-95.2) and almost half (46.3%) of the 3-month post-discharge suicides occurred within 14 days after discharge. The adjusted hazard of committing suicide for patients who were not hospitalized in the preceding year was 1.68 (p=0.009), 1.61 (p=0.033), and 2.51 (p<0.001) times greater, respectively, than patients who were hospitalized once, twice and more than twice within the year before index hospitalization. The hazard of committing suicide among patients who were unemployed was 1.71 (p<0.001) times that of their employed counterparts.

Conclusions: We conclude that, while our study was limited to suicides among cancer patients within 90 days of discharge, around 60% of deaths occurred within the first month after discharge. The relevant risk factors include the number of hospitalizations within 1 year and employment status.