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Injury. 2012 Sep;43(9):1562-5. doi: 10.1016/j.injury.2011.06.005. Epub 2011 Jun 28.

Self harm is an independent predictor of mortality in trauma and burns patients admitted to ICU.

Author information

  • 1Addenbrookes Hospital, Cambridge, UK. ajvarley@doctors.org.uk

Abstract

BACKGROUND:

Patients with mental illness or depression may sustain self-inflicted injuries that require admission to an Intensive Care Unit (ICU). It is unknown whether the intent of injury leads to a greater likelihood of dying over and above the severity of the initial injury. Given the economic and societal burden of injury of self-harm, we designed this study to compare hospital outcomes of intentionally injured patients presenting to a tertiary ICU compared to unintentional injuries.

METHODS:

The regional trauma database was interrogated to produce two datasets that included all adult trauma patients admitted to the Alfred Intensive Care Unit between 01/07/2002 and 30/06/2007. The first included patients that sustained intentional injuries, the second comprised un-intentional injuries and acted as a control group. Logistic regression was used to model factors associated with mortality.

RESULTS:

Intentionally injured patients made up 4.17% of the total burns, blunt and penetrating trauma admissions to the Alfred ICU over the five-year study period. There was a trend towards higher mortality overall and in all subgroups of patients with intentional injuries when compared to those with un-intentional mechanisms of injury. After adjusting for injury severity and age, a mechanism of injury involving intentional injury was independently associated with a doubling of the odds of death.

CONCLUSIONS:

Our study is the first paper in the literature to describe an increased the risk of death within a group of patients admitted to a trauma and burns ICU following deliberate self-harm.

Copyright © 2011 Elsevier Ltd. All rights reserved.

PMID:
21714967
[PubMed - indexed for MEDLINE]
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