TY  - JOUR
PY  - 2019//
TI  - The 2 faces of intentional self-inflicted injury: high in-hospital mortality, low postdischarge mortality, but high readmission rates
JO  - Surgery
A1  - Howe, Katherine L.
A1  - Collier, Bryan R.
A1  - Bath, Jennifer L.
A1  - Lagoy, Julian C.
A1  - Criss, Tracey W.
A1  - Faulks, Emily R.
A1  - Lollar, Daniel I.
A1  - Bower, Katie L.
A1  - Locklear, Tonja M.
A1  - Matos, Miguel A.
A1  - Nussbaum, Michael S.
A1  - Hamill, Mark E.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Intentional self-inflicted injuries present unique challenges in treatment and prevention. We hypothesized intentional self-inflicted injuries would have higher in-hospital and postdischarge mortality than nonintentional self-inflicted injuries trauma. <br><br>METHODS: Adult patients evaluated 2008 to 2012 were identified in our trauma registry and matched with mortality data from the National Death Index. Intentional self-inflicted injuries were identified using E-Codes. Readmissions were identified and analyzed. Intentional self-inflicted injuries patients who died in-hospital were compared with those surviving to discharge. Univariate analysis was performed using nonparametric tests. Kaplan-Meier curves were plotted to compare mortality ≤5 years postdischarge between intentional self-inflicted injuries and non-intentional self-inflicted injuries patients. <br><br>RESULTS: In the study, 8,716 patient records were evaluated with 245 (2.8%) classified as intentional self-inflicted injuries. Eighteen (7.8%) patients with intentional self-inflicted injuries had multiple admissions, compared with 352 (4.4%) patients with nonintentional self-inflicted injuries with readmissions (P =.0210). In-hospital mortality was higher for intentional self-inflicted injuries compared with patients with non-intentional self-inflicted injuries (18.7% vs 4.9%, P <.0001). Survival analysis demonstrated that patients with intentional self-inflicted injuries had significantly lower postdischarge mortality at multiple time points. <br><br>CONCLUSION: Patients with intentional self-inflicted injuries trauma have high in-hospital mortality, but low postdischarge mortality. We attribute this to high lethality mechanisms but appropriate psychiatric treatment and rehabilitation. However, the high intentional self-inflicted injuries readmission rate indicates further study of intentional self-inflicted injuries follow-up is warranted. Better prevention strategies are needed to identify and intervene in patients at-risk for intentional self-inflicted injuries.<br><br>Copyright © 2019 Elsevier Inc. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0039-6060
UR  - http://dx.doi.org/10.1016/j.surg.2019.04.037
ID  - ref1
ER  -