scholarly journals Increased number of cases of giant cell arteritis and higher rates of ophthalmic involvement during the era of COVID-19

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Rosamond Luther ◽  
Sarah Skeoch ◽  
John D Pauling ◽  
Christopher Curd ◽  
Felicity Woodgate ◽  
...  
Keyword(s):  
Medical Records ◽  
Fast Track ◽  
Temporal Artery ◽  
Temporal Artery Biopsy ◽  
Duration Of Symptoms ◽  
Time Period ◽  
Number Of Patients ◽  
Male Patients ◽  
The Uk ◽  
Made In

Abstract Objectives Our centre offers a fast-track assessment service for patients with suspected GCA and this service continued to operate during the coronavirus disease 2019 (COVID-19) pandemic. During and immediately following the peak of the COVID-19 pandemic in the UK we observed an increase in the number of patients diagnosed with GCA as well as an increased number of patients with visual complications. Our aim was to investigate this further. Methods The electronic medical records of all patients referred for GCA fast-track assessment from January 2019 were reviewed. A complete list of patients undergoing temporal artery ultrasound and temporal artery biopsy for investigation of GCA dating back to 2015 was also available. Results In the 12 week period between April and June 2020, 24 patients were diagnosed with GCA. Six (25%) had associated visual impairment. In contrast, during 2019, 28 new diagnoses of GCA were made in total and just 10% of patients suffered visual involvement. The number of patients diagnosed with GCA in April–June 2020 was nearly 5-fold that of the same time period the previous year. GCA diagnoses between April and June 2020 were supported by imaging (temporal artery ultrasound or CT-PET) in 72% of cases. We noted a higher proportion of male patients and a lower median age but no clear difference in the duration of symptoms prior to assessment. Conclusions The reasons behind our observations remain unclear. However, our findings support the viral aetiopathogenesis hypothesis for GCA and demonstrate the importance of maintaining access to urgent rheumatology services during periods of healthcare disruption.

scholarly journals OP0150 WHAT IS THE ROLE OF TEMPORAL ARTERY BIOPSY IN GIANT CELL ARTERITIS FAST-TRACK PATHWAYS WHEN TEMPORAL ARTERY ULTRASOUND IS NEGATIVE?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 95.3-95
Author(s):  
A. Sachdev ◽  
S. Dubey ◽  
C. Tiivas ◽  
M. George ◽  
P. Mehta
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Sensitivity And Specificity ◽  
Fast Track ◽  
Temporal Artery ◽  
Clinical Findings ◽  
Specimen Size ◽  
Temporal Artery Biopsy ◽  
Duration Of Treatment ◽  
Relevant Role

Background:A number of centres are now running fast track pathways for diagnosis and management of Giant cell arteritis with ultrasound as the first port of call for diagnosis1. Temporal artery biopsies (TABs) have become the second line of investigation, and it is unclear how useful TAB is in this setting.Objectives:This study looked at accuracy of Temporal artery biopsy (TAB) in patients with suspected Giant Cell arteritis (GCA) with negative/inconclusive ultrasound (U/S) and how duration of treatment on steroids prior to these investigations and arterial specimen size affected it.Methods:Prospective study of all patients with suspected GCA referred for TAB when U/S was negative or inconclusive, as part of the local fast-track pathway (Coventry). Database included clinical findings, serological work up, U/S and TAB results and treatment. Sensitivity and specificity of U/S and TAB was calculated and compared based on duration of treatment with steroids.Results:One hundred and nine patients were referred for TAB via Coventry fast-track-pathway. The sensitivity of U/S in this cohort of patients was 9.08% and specificity was 93.33%. After 3 days of steroid this was 0% and 100% respectively. For TAB when done within 10 days of starting steroids, this was 65% and 87.5% respectively. After 20 days of steroids this was 0 % and 100%. The sensitivity and specificity was 20% and 85% when arterial specimen size was 11-15mm and 47% and 100% when specimen size was 16 mm or more. Sensitivity and specificity of U/S of 644 suspected GCA patients was 48% and 98%.Conclusion:Our study demonstrates that TAB plays a relevant role in GCA fast-track-pathways, when U/S is negative/inconclusive. TAB was more sensitive than U/S in this cohort of patients, but overall sensitivity of U/S was higher when calculated for all patients suspected with GCA. Both remain useful tests if performed early. TAB specimen size should ideally be 16mm or more and done within 10 days of starting steroids.References:[1]Jonathan Pinnell, Carl Tiivas, Kaushik Chaudhuri, Purnima Mehta, Shirish Dubey, O38 The diagnostic performance of ultrasound Doppler in a fast-track pathway for giant cell arteritis,Rheumatology, Volume 58, Issue Supplement_3, April 2019, kez105.036,https://doi.org/10.1093/rheumatology/kez105.036Disclosure of Interests:None declared

scholarly journals The fast-track outpatient clinic significantly decreases hospitalisation rates among polymyalgia rheumatica patients

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Stavros Chrysidis ◽  
Philip Rask Lage-Hansen ◽  
Nikoletta Svendsen ◽  
Andreas P. Diamantopoulos
Keyword(s):  
Polymyalgia Rheumatica ◽  
Fast Track ◽  
Clinical Symptoms ◽  
Classification Criteria ◽  
Duration Of Symptoms ◽  
Prednisolone Dose ◽  
South West ◽  
Hospitalised Patients ◽  
Number Of Patients ◽  
The Impact

Abstract Objectives This study aimed to investigate the hospitalisation rates and the reasons for hospitalisation in patients with polymyalgia rheumatica (PMR). Furthermore, it aimed to clarify the impact of a newly established Fast Track Clinic (FTC) approach on hospitalisation rates in connection with PMR diagnosis. Methods Patients diagnosed with PMR at South-West Jutland Hospital, Denmark, between 2013 and 2018 were included retrospectively. Only patients fulfilling the 2012 EULAR/ACR classification criteria were included in our cohort. An FTC for patients suspected of having PMR was established in the rheumatologic department of South-West Jutland Hospital in January 2018. Results Over 6 years (2013 to 2017), 254 patients were diagnosed with PMR, 56 of them while hospitalised. Hospitalised patients were more likely to have a higher initial CRP mean ± standard deviation (SD) 99.53 ± 59.36 vs 45.82 ± 36.96 mg/lt (p <  0.0001) and a shorter duration of symptoms (p = 0.0018). After implementing the FTC, a significant decrease in hospitalisation rates (from 20.4% to 3,5%) and inpatient days of care (mean ± SD 4.15 ± 3.1 vs 1 ± 0) were observed. No differences between the two groups were observed regarding clinical symptoms, laboratory values and initial prednisolone dose. Conclusion A substantial number of patients are hospitalised in connection with the PMR diagnosis. The FTC approach can decrease the hospitalisation rates significantly among these patients. Trial registration Retrospectively registered.

AB0488 CAN A GCA RISK STRATIFICATION SCORE BE HELPFUL IN CLINICAL PRACTICE?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1541.1-1542
Author(s):  
M. Jasim ◽  
P. Magan ◽  
R. Awadalla ◽  
R. Brindley ◽  
D. Richards ◽  
...  
Keyword(s):  
Prediction Model ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Diagnostic Test ◽  
Scoring Systems ◽  
Temporal Artery ◽  
Low Risk ◽  
Temporal Artery Biopsy ◽  
Number Of Patients ◽  
Risk Probability

Background:Giant cell arteritis (GCA) is the most common type of large vessel vasculitis. Typically it presents in patients over the age of 50 with a combination of temporal headaches, scalp tenderness, jaw claudication, raised inflammatory markers and visual disturbance. The diagnosis of GCA is often challenging and there is a difficult balance of over and under investigation. There have been several proposed scoring systems to help clinicians risk stratify patients who may present with suspected GCA. One such scoring system, published in 2017, showed clinical utility in a large international multi-centre study. Following analysis by logistic regression on data from 530 biopsies, Ing et al. developed a parsimonious prediction model comprising 5 candidate criteria: age, jaw claudication, ischemia-related loss of visual acuity, platelet count and logCRP (Figure 1).[1]Objectives:Increasingly, ultrasound doppler imaging is recognised and accepted as satisfactory means of confirming the diagnosis of GCA, with the presence of the halo sign characteristic for GCA. The aim of our study was to determine whether this GCA prediction model accurately predicts positive temporal artery biopsies in a large, real world UK cohort. In addition, we assessed whether this model accurately predicts positive temporal artery ultrasounds.Methods:A retrospective cohort study was performed using electronic medical records of patients referred for temporal artery biopsy (TAB) and temporal artery ultrasound (USTA) for suspected GCA. All TAB performed at the Royal Wolverhampton NHS Trust between June 2014 - June 2018 and all USTA performed between January 2015 - January 2019 were analysed. Patients who undergo USTA for suspected GCA at our centre routinely have bilateral temporal and axillary arteries scanned. Patients were excluded if they already had a previous diagnosis of GCA (and the clinical question was suspected flare), or if there was insufficient information available.Results:The total number of patients who underwent a confirmatory diagnostic test (either TAB or USTA) for suspected GCA was 187. Thirteen of these patients met the exclusion criteria, the remaining 174 patients were included for analysis. 126/174 patients underwent a TAB, 63/174 had an USTA. 15/174 had both these were included in the USS cohort because for all these patients the ultrasound was the first diagnostic test performed (Table 1). Our results appear to closely mirror the original multi-centre results with regards to prediction of biopsy positive GCA, with the centiles closely following those in the inception cohort. 0% of the ‘low’ risk probability biopsy cohort were misclassified - none had a positive biopsy. However, 8% of the ‘low’ risk probability ultrasound cohort were misclassified - 2 had a positive ultrasound.Table 1.Investigation outcome summaryTotal number of patients who underwent TAB +/or USS TA for?GCA187 - 13 patients rejectedN = 174TAB = 111USS = 63Of these 15 patients hadbothUSS & TABPositive TAB =31 (28%)Negative TAB =80 (72%)Positive USS =24 (38%)Negative USS =39 (62%)Conclusion:Our study, highlights that a probability score for GCA derived from a large multi-centre cohort of patients who were biopsy positive, predicts ultrasound positivity with similar accuracy. Our work reveals that scoring systems are not infallible but can be helpful in guiding clinical decision makingReferences:[1]Ing EB, Lahaie Luna G, Toren A, et al. Multivariable prediction model for suspected giant cell arteritis: development and validation.Clin Ophthalmol. 2017;11:2031–2042. Published 2017 Nov 22.Acknowledgments:Many thanks to the Rheumatology, Opthalmology & Ultrasound teams at Royal Wolverhampton NHS TrustDisclosure of Interests:None declared

scholarly journals P187 Not a headache clinic: giant cell arteritis fast track pathways (GCA-FTP) need not be overwhelming

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Luke Spray ◽  
Gary Reynolds ◽  
Karolyn Houghton ◽  
Ben Hargreaves ◽  
Jonathon Heaney ◽  
...  
Keyword(s):  
Fast Track ◽  
Primary Headache ◽  
Temporal Artery ◽  
High Dose ◽  
Duration Of Symptoms ◽  
Headache Diagnosis ◽  
High Tariff ◽  
Headache Clinic ◽  
Term Management

Abstract Background False positive and negative GCA diagnoses lead to significant morbidity. GCA Fast Track Pathways (GCA-FTP) are advocated in the NHS. Concern that these become ‘headache clinics’, lack of access to temporal artery ultrasound (TAUS) and biopsy (TAB) are cited as barriers to provision. We present prospectively collected data from referrals to our GCA-FTP demonstrating that this has not occurred in our service. Methods Rheumatology leads our GCA-FTP providing initial investigation, TAUS for all patients and long-term management when GCA is diagnosed. Ophthalmology is the point of access for patients with visual symptoms and, if required, TAB. Results Referral numbers for calendar years 2014 through 2018 were 70, 97, 134, 180 & 175 respectively. TAB was requested for 29, 43, 49, 57 and 41 patients and GCA diagnosed in 29, 34, 33, 43 & 40 patients per year. In 2017-18, TAUS without biopsy supported a diagnosis of GCA in 58 and excluded it in 199. Across 2017 and 2018 we received 356 referrals: 43.5% from ophthalmology, 34.3% primary care and 11.0% medicine. 59.3% were on corticosteroids. Mean age was 71 years, 73.3% were female. GCA was diagnosed in 83 (23.3%). Mean duration of symptoms at first review was 38 ±4.4 days in GCA patients and 58 ±6.4 days in non-GCA patients. Characteristic GCA clinical features were significantly higher in the GCA group (Table 1). Non-GCA final diagnoses were ophthalmic (NIAON) (13.8%) and musculoskeletal related (12.2%). 7.0% of patients received a primary headache diagnosis. In 41.4% no cause was recorded, and patients were discharged to their GP with corticosteroids stopped. Conclusion A GCA-FTP can be a predictable service to manage. Clinical review by an experienced doctor distinguishes many non-GCA presentations from GCA when seen promptly. Most patients with GCA will be seen by rheumatology during their disease course. Distinguishing non-GCA diagnoses at later time points is significantly more challenging and means patients are exposed unnecessarily to high dose steroid, often for many months. TAUS and TAB are useful adjuncts to diagnosis and required for use of high tariff drugs. Lack of access need not however mean deferring setting up a GCA-FTP. Disclosures L. Spray None. G. Reynolds None. K. Houghton None. B. Hargreaves None. J. Heaney None. B. Thompson None. A. Lorenzi None.

scholarly journals P37: THE IMPACT OF TEMPORAL ARTERY BIOPSY AT A UK TERTIARY PLASTIC SURGERY UNIT

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
BJW Chew ◽  
A Khajuria ◽  
J Ibanez
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Steroid Therapy ◽  
Temporal Artery ◽  
Clinical Suspicion ◽  
Temporal Artery Biopsy ◽  
Diagnostic Uncertainty ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Introduction Guidelines recommend temporal artery biopsy (TAB) for patients suspected of having giant cell arteritis (GCA). We evaluated the impact of TAB on the diagnosis and management of patients with suspected GCA at a tertiary plastic surgery unit. Method A retrospective review of all TAB procedures performed at our centre over 7 years was performed. One hundred and one patients were included in the study. Patients were classified into 3 diagnostic groups: confirmed (positive TAB), presumed (negative TAB with high clinical suspicion) and unlikely (negative TAB with low clinical suspicion). The clinical presentation and management for each group were compared. Result The average American College of Rheumatology (ACR) score was 3.07. The number of patients with an ACR score of ≥3 before TAB was 72 (71.3%) and remained the same after TAB. The number of patients who remained on steroid therapy was lower in the group with an unlikely diagnosis of GCA compared to the group with a confirmed diagnosis (p&lt;0.05). Conversely, there was no significant difference in steroid therapy between those with a presumed and confirmed diagnosis (p&gt;0.05). Conclusion This study found a significant difference in steroid treatment between those with confirmed GCA and those where the diagnosis was unlikely showing that TAB may support decisions regarding steroid therapy. However, TAB was inappropriately requested for patients whose pre-TAB ACR score was ≥3 as this score is sufficient for the diagnosis of GCA. Therefore, the use of TAB should be limited to cases of diagnostic uncertainty. Take-home message while temporal artery biopsy has a role to play in the diagnosis of GCA, its use should be limited to cases of diagnostic uncertainty and not requested for every patient with a suspicion of Giant Cell Arteritis.

Temporal Small-Vessel Inflammation in Patients with Giant Cell Arteritis: Clinical Course and Preliminary Immunohistopathologic Characterization

2010 ◽  
Vol 38 (2) ◽  
pp. 331-338 ◽  
Author(s):  
ELISE BELILOS ◽  
JUDY MADDOX ◽  
ROBERT M. KOWALEWSKI ◽  
JOLANTA KOWALEWSKA ◽  
GEORGE K. TURI ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Clinical Features ◽  
Temporal Artery ◽  
Small Vessel ◽  
Temporal Artery Biopsy ◽  
Cellular Composition ◽  
Positive Biopsy ◽  
Number Of Patients ◽  
Negative Biopsies

Objective.To investigate the occurrence, clinical correlates, and immunohistochemical phenotype of temporal small-vessel inflammation (TSVI) in temporal artery biopsies from patients presenting with clinical features of giant cell arteritis (GCA).Methods.We retrospectively reviewed 41 temporal artery biopsy specimens for the presence of inflammatory infiltrates in small vessels external to the temporal artery adventitia (TSVI); 33 had sufficient clinical and pathological data for detailed analysis. Clinical and laboratory features at presentation and corticosteroid treatment patterns of patients with isolated TSVI were compared to those of patients with positive and negative biopsies. The cellular composition of the infiltrates was further characterized by immunohistochemistry.Results.Twenty-three (70%) specimens had evidence of TSVI including 10 with concurrent GCA and 13 (39%) with isolated TSVI. TSVI was found in all positive temporal artery biopsies. The proportion of macrophages and of lymphocyte subpopulations differed between infiltrates observed in TSVI and those of the main temporal artery wall. Initial erythrocyte sedimentation rate (ESR) was similar in the TSVI and positive biopsy groups and was significantly higher than in the negative biopsy group. Patients with isolated TSVI more often had symptoms of polymyalgia rheumatica compared to the positive biopsy group. Patients with TSVI received corticosteroid doses that were intermediate between patients with positive and those with negative biopsies.Conclusion.A significant number of patients with clinical features of GCA demonstrated isolated TSVI. Differences in the clinical presentation and cellular composition suggest that TSVI may represent a subset of GCA and should be considered in the interpretation of temporal artery biopsies and treatment decisions.

scholarly journals Lumbosacral pain caused by blockage of dynamic vertebrogenic segments of thoracolumbar transition

2011 ◽  
Vol 1 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Sead Čebić ◽  
Džemal Pecar ◽  
Muris Pecar ◽  
Suvad Šivić
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Medical Records ◽  
Low Back ◽  
Number Of Patients ◽  
Thoracolumbar Transition ◽  
Male Patients ◽  
One Year ◽  
Number Of Males ◽  
Private Specialist

Introduction: In the case of the Thoraco-lumbar Junction Syndrome the pain is located in the region of the lumbo-sacral junction. Sudden torsion movements and lifting of objects while the spine is in position of torsion is the cause in most cases. In those cases, a blockade on the  Th11-Th12-L1 vertebrae occurs. The aim of this research was to determine the number of patients with the Low Back Pain whose origin is in the thoracic vertebral dynamic segments, in relation to the total number of patients according to gender, age and profession.Methods: In this retrospective, descrtiptive study we have analyzed patients treated for Lumbosacral syndrome of thoracic origin in private specialist ambulant “Cebic” in Zavidovici during one year period. We analyzed data from patients medical records and history.Results: Total of 1882 patients were treated for the Low Back Pain, of which 67 (3.56%) had an origin of the pain in the Thoraco-lumbar Junction. In the analyzed group, there were 49 (73.1%) man and 18 (26.8%) women. The largest number of males, 21 (42.8%), were between 40-49 years old, while the largest number of woman, 9 (50%), was 20 to 29 years old. Largest number of male patients, 35 (71.8%), were physical workers, while most of the female subjects, 7 (38.8%), were of ce workers.Conclusions: Our research concludes that the number of patients with Low Back Pain of the thoracic origin (3.56%) is not disregarded, but these facts are usually overlooked. Therapy for those kinds of patients is in most cases concentrated to the lower segments of the lumbar spine, which gives unsatisfactory therapeutic results.

scholarly journals EVALUASI PENGGUNAAN OBAT PADA PASIEN PPOK (PENYAKIT PARU OBSTRUKTIF KRONIS) DI INSTALASI RAWAT JALAN RSUP PROF. DR. R.D. KANDOU MANADO

PHARMACON ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 630
Author(s):  
Rochmat Hidayat Hathasary ◽  
Weny Wiyono ◽  
Deby Afriani Mpila
Keyword(s):  
Drug Use ◽  
Medical Records ◽  
Drug Evaluation ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Number Of Patients ◽  
Retrospective Data Collection ◽  
Male Patients ◽  
Receive Treatment ◽  
The Right

ABSTRACTChronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease characterized by limited airflow in the airways that is not completely reversible and is progressive. The accuracy of drug use in this study is that patients receive treatment which is then evaluated for its accuracy based on the right category of indication, right drug, right patient, and right dose. This study aims to identify the characteristics and presentation of the accuracy of drug use in COPD patients. This study is a descriptive study with retrospective data collection from 30 medical records of  COPD patients for the period July - September 2020. The results of the study based on the characteristics of COPD patients showed that the number of male patients was greater than that of women, namely 23 patients (76.67%) and The highest number of patients was in the 56-65 years age group of 13 patients (43.33%). Diseases of the digestive system were the most common comorbidities found in 2 patients (6.67%) and 3-4 drugs were prescribed more, namely in 16 patients (53.34%). The percentage of accuracy of drug use consisted of 93.33% right indication, 53.33% right drug, 100% correct patient, and 96.67% correct dose. Keywords: drug evaluation , COPD, outpatient  ABSTRAKPenyakit Paru Obstruksi Kronik (PPOK) adalah penyakit paru kronik yang ditandai dengan keterbatasan aliran udara di dalam saluran napas yang tidak sepenuhnya reversible dan bersifat progresif. Ketepatan penggunaan obat dalam penelitian ini adalah pasien menerima pengobatan yang kemudian di evaluasi ketepatannya berdasarkan kategori tepat indikasi, tepat obat, tepat pasien, dan tepat dosis.Penelitian ini bertujuan untuk mengidentifikasi karakteristik dan presentasi ketepatan penggunaan obat pada pasien PPOK. Penelitian ini merupakan penelitian deskriptif dengan pengambilan data secara retrospektif dari 30 catatan rekam medik pasien PPOK periode Juli - September 2020. Hasil penelitian berdasarkan karakteristik pasien PPOK menunjukkan jumlah pasien laki-laki lebih banyak dibanding perempuan yaitu sebesar 23 pasien (76,67%) dan jumlah pasien terbanyak pada kelompok usia 56-65 tahun sebesar 13 pasien (43,33%). Penyakit pada sistem pencernaan merupakan penyakit penyerta terbanyak yang ditemukan pada 2 pasien (6,67%) dan 3-4 obat diresepkan lebih banyak yaitu pada 16 pasien (53,34%). Persentase ketepatan penggunaan obat terdiri dari tepat indikasi 93,33%, tepat obat 53,33%, tepat pasien 100%, dan tepat dosis 96,67%. Kata kunci: Evaluasi Obat, PPOK, rawat jalan

Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Interview ◽  
Clinical Variables ◽  
Completed Suicide ◽  
Number Of Patients ◽  
Group A ◽  
Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

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