Citation

Stanford RE, Soden R, Bartrop R, Mikk M, Taylor TK. Spinal Cord 2007; 45(6): 437–443.

Affiliation

Department of Orthopedics, Prince of Wales Hospital and University of New South Wales, Sydney NSW, Australia.

Copyright

(Copyright © 2007, International Spinal Cord Society, Publisher Nature Publishing Group)

DOI

10.1038/sj.sc.3102043

PMID

17339888

Abstract

Study Design:Retrospective analysis of acute spinal cord injuries (ASCI).Objectives:Determine incidence of ASCI due to suicide attempt from 1970 to 2000. Describe demographics, injuries, mental illness, functional outcomes and nature of subsequent deaths.Setting:State spinal cord injury services, New South Wales, Australia.Methods:Retrospective record review and follow-up interview.Results:Of 2752 ASCI admissions, 56 were because of attempted suicide (55 falls, one gun-shot wound). Thirty-six males and 20 females. Median age 30 years (15-74). Most common levels of vertebral injury were C5 and L1. Twenty-three had complete spinal cord injury. Thirty-two had an Injury Severity Score of >15. Forty had more than one major injury. There was a significant rise in the incidence of ASCI following self-harm over time (Poisson regression, P=0.004). There was a significant change in scene of injury away from hospitals over time (chi (2) test, df=1, P= 0.0001). Psychiatric diagnoses were personality disorder 27; schizophrenia 16; depression 14; chronic alcohol abuse 10; mood disorder 10; chronic substance abuse 10; other four. Follow-up was available in 47 cases (84%) at an average of 8 years. Four subsequent deaths were by suicide. Domiciliary arrangements were: home 28; hospital five; nursing home three; group home/hostel four.Conclusions:Community placement outcomes for survivors were good. Subsequent death by suicide was high. There was a significant rise in cases and a change in injury scene away from hospitals over time.

Language: en