Background The suicide case-fatality rate (CFR)-the proportion of suicidal acts that are fatal-depends on the distribution of methods used in suicidal acts and the probability of death given a particular method (method-specific CFR). Objective To estimate overall and method-specific suicide CFRs and the distribution of methods used in suicidal acts by demographic characteristics. Design Cross-sectional study. Setting United States, 2007 to 2014. Participants Suicide deaths (n = 309 377 records from the National Vital Statistics System) and nonfatal suicide attempts requiring treatment in an emergency department (ED) (n = 1 791 638 records from the Nationwide Emergency Department Sample) or hospitalization (n = 1 556 871 records from the National [Nationwide] Inpatient Sample) among persons aged 5 years or older. Measurements Rates of suicide deaths and nonfatal suicide attempts, overall and method-specific CFRs, and distribution of methods used, by sex, age group, region, and urbanization. Results Overall, 8.5% of suicidal acts were fatal (14.7% for males vs. 3.3% for females; 3.4% for persons aged 15 to 24 years vs. 35.4% for those aged ≥65 years). Drug poisoning accounted for 59.4% of acts but only 13.5% of deaths; firearms and hanging accounted for only 8.8% of acts but 75.3% of deaths. Firearms were the most lethal method (89.6% of suicidal acts with a firearm resulted in death), followed by drowning (56.4%) and hanging (52.7%). Method-specific CFRs were higher for males and older persons. The distribution of methods varied across demographic groups. Limitations Results are based on suicidal acts resulting in an ED visit, a hospitalization, or death. Consequently, the reported CFRs are larger than they would have been had the data included nonfatal attempts that did not result in an ED visit. Conclusion Variation in overall suicide CFR between sexes and across age groups, regions, and urbanization is largely explained by the distribution of methods used in suicidal acts. Primary Funding Source Joyce Foundation.

中文翻译：

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美国2007年至2014年自杀病例死亡率：一项基于全国人口的研究。

背景自杀致死率（CFR）-致命自杀行为的比例-取决于自杀行为所用方法的分布以及给定特定方法（特定方法CFR）的死亡概率。目的根据人口统计学特征估算自杀行为的总体和特定方法，以及自杀行为中使用的方法的分布。设计横断面研究。设置美国，2007年至2014年。参与者的自杀死亡（国家生命统计系统的n = 309377记录）和需要在急诊部门接受治疗的非致命性自杀未遂（n =全国急诊部门样本中的1 791 638条记录） ）或住院（年龄在5岁或以上的人中，n = 1 556 871记录来自国家[全国]住院样本）。度量按性别，年龄组，地区和城市化程度划分的自杀死亡和非致命自杀企图的比率，总体和特定方法的病死率以及所用方法的分布。结果总体而言，自杀行为有8.5％是致命的（男性为14.7％，女性为3.3％； 15至24岁的人为3.4％，而65岁以上的人为35.4％）。毒品中毒占行为的59.4％，但仅占死亡的13.5％；枪支和绞刑仅占行为的8.8％，但占死亡的75.3％。枪支是最致命的方法（89.6％的枪支自杀行为导致死亡），其次是溺水（56.4％）和吊死（52.7％）。男性和老年人的方法特定病死率较高。方法的分布在不同人群之间有所不同。局限性结果是基于导致急诊就诊，住院，或死亡。因此，所报告的病死率比如果数据包括未进行急诊就诊的非致命性尝试要大。结论自杀行为使用的方法的分布在很大程度上解释了性别之间以及年龄段，地区和城市化过程中总体自杀CFR的差异。主要资金来源乔伊斯基金会。