DOI: 10.22391/fppc.1847392 ISSN: 2458-8865

Peripheral inflammatory hematological markers and psychiatric hospitalization decisions after suicide attempts: a retrospective study

Muhammet Sevindik, Halit Canberk Aydogan, Beyzanur Yahşi Uzun, Çağıl Aydin Çetiner, Ferhan Güvenç, Ali Aygun
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Introduction: Suicide is a major global public health concern, and growing evidence suggests that systemic inflammation may play a role in its pathophysiology. Hematological inflammatory parameters such as red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) have been proposed as potential biomarkers in psychiatric conditions. However, their association with clinical decision-making following suicide attempts remains underexplored. This study aimed to compare peripheral inflammatory markers between patients recommended for psychiatric hospitalization and those discharged after suicide attempts.Methods: This retrospective study included 107 adult patients who presented to the emergency department of Ordu University Training and Research Hospital between 2022 and 2025 following a suicide attempt. Based on psychiatric consultations, patients were categorized into two groups: those who were discharged and those recommended for inpatient psychiatric hospitalization. Hematological parameters—including RDW, MPV, CRP, WBC, neutrophil, lymphocyte, monocyte, basophil, and eosinophil counts—and calculated indices such as NLR, PLR, SII, and SIRI (Systemic Inflammatory Response Index) were analyzed. Group comparisons were made using the Mann–Whitney U test or t-test, and multivariate logistic regression was performed to assess independent predictors. Cohen’s d was calculated to determine effect sizes.Results: A total of 107 patients (69 women and 38 men) were included in the study. Of these patients, 73 were discharged from the emergency department, and 34 were recommended for psychiatric hospitalization. The RDW value was significantly higher in the group recommended for psychiatric hospitalization than in the discharged group (median 13.4 vs. 12.9; p = 0.011), with a moderate effect size (Cohen’s d = 0.50). Other parameters such as NLR, PLR, and SII had higher median values ​​in the group recommended for hospitalization, but did not reach statistical significance. In the multivariate logistic regression analysis adjusted for age and sex, RDW was not found to be statistically significant (p = 0.094).Conclusions: This study indicates that there may be limited differences in hematological inflammatory parameters between patients who were recommended for psychiatric hospitalization following a suicide attempt and those who were discharged. The findings should be interpreted with caution due to methodological limitations, and further prospective studies with larger sample sizes are needed to clarify this issue.

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