What is the clinical evidence from this study?

Study design: Observational. Population: Self-harm or suicide attempts (n=1757). Intervention: Public assistance status vs. Non-recipients of public assistance. Primary outcome: Suicide-related cardiac arrest (aIRR 3.34, 95% CI 1.60-6.95).

What question did this study set out to answer?

This research aims to examine the link between public assistance status and the incidence of suicide-related cardiac arrest.

June 20, 2026Open Access

Public assistance and suicide-related cardiac arrest in emergency departments: a nationwide registry-based study in Japan

FSFumiya SasaiOkayama University THTakashi HongoOkayama University YYY. YamamuraOkayama University

Key Result

Public assistance status was associated with a significantly higher population-level incidence of suicide-related cardiac arrest compared to non-recipients (aIRR 3.34).

Key Points

This research aims to examine the link between public assistance status and the incidence of suicide-related cardiac arrest.
Nationwide registry-based study conducted in Japan
Analysis of emergency department presentations
Population-level data capturing suicide-related cardiac arrest events
Higher rates of suicide-related cardiac arrest observed among individuals on public assistance
Significant correlation between public assistance status and cardiac arrest events due to suicide

Study Design

Type

Observational (n=1,757)

Multicenter

Yes

Structured PICO

Is public assistance status associated with suicide-related cardiac arrest in emergency department presentations?

Population

1,757 patients (median age 33, 63.7% female) presenting to tertiary emergency and critical care centers following self-harm or suicide attempts in Japan.

Exposure

Public assistance status

Outcome

Suicide-related cardiac arresthard clinical

Main Result

Relative Risk: 3.34 (95% CI 1.6–6.95)

Absolute Event Rate: 3.9% vs 9.7%

Limitations

Lack of detailed information on potential confounders such as duration of public assistance, specific psychiatric diagnoses, and degree of social isolation.
Study population limited to 57 of 304 designated tertiary emergency and critical care centers, not representing the full spectrum of self-harm in the general population.
Use of general population as denominator may bias IRRs if access to emergency care differs by socioeconomic status.
Exemption from medical copayments for public assistance recipients may lead to overestimation of IRRs due to more frequent presentations for less severe self-harm.
Inability to identify repeat visits by the same individual due to privacy protections.

Abstract

Background: Individuals receiving public assistance have been reported to be at increased suicide risk; however, evidence from emergency medical settings remains limited. This study investigated the population-level association between public assistance status and suicide-related cardiac arrest using events captured through emergency department presentations.

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Cite This Study

Sasai et al. (Thu,) conducted a observational in Self-harm or suicide attempts (n=1,757). Public assistance status vs. Non-recipients of public assistance was evaluated on Suicide-related cardiac arrest (aIRR 3.34, 95% CI 1.60-6.95). Public assistance status was associated with a significantly higher population-level incidence of suicide-related cardiac arrest compared to non-recipients (aIRR 3.34).

synapsesocial.com/papers/6a3721e201fe431c2518897e https://doi.org/https://doi.org/10.2188/jea.je20260116

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