Impact of COVID-19 on Acute Care Hospitalizations for Suicidality

• Published in: Hospital pediatrics Vol. 14; no. 5; p. 376
• Main Authors: Dellazoppa, Alicia, Porada, Kelsey, Zaspel, Jennifer A, Bourgeois, Shay, Vepraskas, Sarah H
• Format: Journal Article
• Language: English
• Published: United States 01.05.2024
• Subjects: Adolescent; Child; COVID-19 - epidemiology; Female; Hospitalization - statistics & numerical data; Hospitals, Pediatric; Humans; Length of Stay - statistics & numerical data; Male; Patient Readmission - statistics & numerical data; Retrospective Studies; Suicidal Ideation; Suicide, Attempted - statistics & numerical data
• ISSN: 2154-1671
• DOI: 10.1542/hpeds.2023-007666

The coronavirus disease 2019 (COVID-19) pandemic contributed to the public health crisis for pediatric mental health. We characterized our local patient population presenting with suicidality or suicide attempts before and after the pandemic by examining: 1. frequencies of hospitalizations for suicidality to determine whether they differed by age, legal sex, race and ethnicity, or socioeconomic status; 2. average length of stay and discharge disposition; 3. 7-, 30-, and 365-day reutilization rates; and 4. admission trends during COVID-19 surges. Retrospective data between March 2018 and March 2022 was analyzed, including patients ages 10 to 17 years hospitalized for either suicidality or a suicide attempt at 1 freestanding tertiary care pediatric medical hospital in the Midwest. Encounters were divided into 2 categories on the basis of the COVID-19 pandemic: "Prelockdown" (March 1, 2018-March 12, 2020) and "postlockdown" (March 13, 2020-March 31, 2022). Patients were limited to 1 presentation pre- and postlockdown. We analyzed frequencies using means and SDs, categorical data using χ2 and Fisher's exact tests, and continuous data with t tests. A total of 1017 encounters were included, stratified into pre- and postlockdown groups for analysis (909 encounters, 889 unique patients). There was a significant difference in 365-day reutilization pre- and postlockdown when analyzing re-presentation to the emergency department (P = .025) and hospital readmission (P = .006). Admissions incrementally increased after the COVID-19 alpha variants in September 2020 and again after the delta variant in August 2021. The COVID-19 pandemic further intensified the already critical issue of pediatric mental health, demonstrating increased reutilization in the year after their initial presentation and an increase in admissions after the alpha variant.