A community-based study of case fatality proportion among those who carry out suicide acts

Objective: To investigate the case fatality proportion and associated factors in those carrying out suicide acts in Nantou, Taiwan. Method: Data from 1,171 suicide acts (including 973 with deliberate self harm and 198 completed suicides), identified between July 2000 and February 2003, were collected from a population suicide register in Nantou County, Taiwan. Case fatality proportion and the independent effects of demographic factors and suicide method on case fatality were investigated. Results: The overall case fatality proportion was 16.9%, with higher proportions in men (26.3%) and in those aged 65 and over (37.9%). Hanging was the most lethal method (fatality proportion = 81.5%); pesticide was both commonly used and associated with a high case fatality (fatality proportion = 26.3%). Only age (increased with age) and suicide method were found to be independently associated with the risk of fatality. Conclusions: Suicide method and older age are independent predictors of the fatality of suicide acts. Suicide prevention strategy and clinical assessment ought to take into account of these two factors. Diminution of pesticide toxicity and control of access to pesticides are important considerations for suicide prevention in rural Taiwan.