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Suicide attempts involving firearms were far more likely to be fatal than attempts using other methods, according to an analysis of hospitalization data.

Of more than 3.6 million suicidal acts recorded in several U.S. government databases from 2007 to 2014, only 4.8% involved firearms, reported Andrew Conner, BS, of Quinnipiac University in North Haven, Connecticut, and colleagues.

But of those, 89.6% were fatal, they wrote in the .

"This study helps to highlight the fact that means matter," Conner told MedPage Today. "I think this will encourage more clinicians to speak with patients about the risk of firearms in the home whether treating people acutely at risk for suicide [or] in a primary care setting."

The can be affected by its accessibility, how easily it can be aborted mid-attempt, and its inherent deadliness, among other factors.

Conner and colleagues used 2007-2014 discharge records and mortality data from the Nationwide Emergency Department Sample (NEDS), the National Inpatient Sample (NIS), and the National Vital Statistics System. Patients were included multiple times in the analysis if they attempted suicide more than once.

Overall, 3,657,886 suicidal acts were identified, of which 309,377 (8.5%) were fatal for a rate of 13.3 suicides per 100,000 in the general U.S. population.

Drug poisoning was the most common method of attempted suicide (59.4%) and was fatal 13.5% of the time. Cutting also accounted for many attempts (21.4%) but was fatal in only 1.8% of cases -- though Conner noted that cutting is not always meant to be fatal.

Attempting suicide through gas poisoning also resulted in death at a relatively high rate (30.5%), although this accounted for just 2.8% of suicide attempts.

As seen in previous studies, deaths from suicide were far more common among males than females (78.4% vs 21.5%), and older people were more likely to die by suicide than younger individuals, regardless of the method used. Rural counties also had modestly higher fatality rates compared to urban counties (16.9 vs 12.7 deaths per 100,000 persons).

These differences can in part be explained by the method that was used, Conner said.

For example, suicidal acts involving firearms were twice as likely to result in deaths among males versus females. About one in four suicidal acts among people 65 or older involved a firearm, whereas just one in 45 individuals under 35 used this method.

Suicide attempts that did not result in hospitalization, as well as nonfatal suicide attempts that were missing electronic codes, were not included in this study, which are limitations, the authors noted. They were also unable to account for race or ethnicity.

The study also didn't cover records after 2014, although Conner said he expects more recent data would not dramatically change the findings, particularly since the overall rate of fatal suicides (8.5%) has appeared fairly stable.

If you or someone you know is considering suicide, call the National Suicide Prevention Hotline at 1-800-273-8255.

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