Risk Factors for Suicidal Ideation and Attempt in Patients With Skull Base Tumors

Objective: Patients with head and neck cancer experience suicide rates significantly higher than the general population. However, the relationship between skull base tumors (SBTs) and suicidal ideation and attempt (SIA) remains underexplored. This study aims to identify sociodemographic and clinical risk factors for SIA among patients with SBTs.

Methods: A retrospective cohort study was conducted using the National Inpatient Sample (2016-2019) to analyze 275,195 hospitalizations involving SBTs. Survey-weighted methods were used to assess univariable and multivariable risk factors for SIA.

Results: Among SBT patients, 2160 (0.78%) were diagnosed with SIA. Younger age (adjusted odds ratio [aOR]: 0.98; P < .001) and emergent admissions (aOR: 2.25; P < .001) were strongly associated with SIA. Socioeconomic difficulties were one of the most significant predictors (aOR: 7.57; P < .001). Depressive, bipolar, and adjustment disorders were the strongest mental health comorbidity predictors (aOR: 8.18, 7.24, 5.19, respectively; P < .001). Alcohol and cannabis use disorders also elevated SIA risk (aOR: 2.79, 2.29, respectively; P < .001). Protective factors included treatment in Western hospitals (aOR: 0.52; P < .001) and undergoing surgery (aOR: 0.29-0.36; P < .001). Meningiomas were associated with lower SIA odds (aOR: 0.68; P = .013), while pituitary adenomas showed a significant association in univariable analysis.

Conclusion: Younger age, socioeconomic difficulties, mental health comorbidities, and substance use are key risk factors for SIA in SBT patients, while surgery and treatment in Western hospitals are protective. Regular suicidality screening and proactive mental health interventions are essential for improving outcomes in this vulnerable population.