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Scand J Trauma Resusc Emerg Med. 2016 May 11;24:68. doi: 10.1186/s13049-016-0261-0.

Characteristics and outcomes of emergency patients with self-inflicted injuries: a report from ambulance records in Osaka City, Japan.

Author information

1
Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, 602-0841, Japan. task-m@koto.kpu-m.ac.jp.
2
Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka Suita, Osaka, 565-0871, Japan.
3
Department of Public Health, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan.
4
Osaka Municipal Fire Department, 1-12-54 Kujo Minami, Nishi-ku, Osaka, 550-8566, Japan.
5
Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto, 606-8501, Japan.
6
Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, 602-0841, Japan.

Abstract

BACKGROUND:

Few studies have evaluated the actual situations of emergency patients with self-inflicted injuries treated by emergency-medical-service (EMS) personnel.

METHODS:

This study retrospectively reviewed population-based ambulance records in Osaka City, Japan, between January 2010 and December 2012, and enrolled emergency patients who suffered from self-inflicted injuries such as poisoning by drugs or gas, cutting/piercing skin, jumping from heights, hanging, and drowning. The endpoint was the annual incidence per 100,000 populations in Osaka City of emergency patients who presented with self-inflicted injuries by age and sex. Their outcomes including deaths at the scene and hospital arrival were also evaluated.

RESULTS:

During the study period, a total of 8,671 patients with 9,424 incidents of self-inflicted injuries were documented. The annual incidence of self-inflicted injuries was higher among women than men in the whole population and in the age group < =49 years (136.9 versus 82.6, and 214.8 versus 93.3, both Ps < 0.001), but it was inversely lower among women in the age group > =50 years (49.0 versus 68.9, P < 0.001). The total number of self-inflicted deaths was 1,564 (16.6 %), and the overall proportion of self-inflicted deaths was greater among men than women (32.2 % [1075/3340] vs. 7.5 % [451/6027], P < 0.001). The proportion of self-inflicted hanging was 76.7 % [1142/1489], followed by poisoning by carbon monoxide at 57.1 % [56/98] and jumping to death at 47.6 % [254/534].

DISCUSSION:

Using large-scale EMS records, we investigated characteristics and outcomes of emergency patients with self-inflicted injuries treated by EMS personnel. Our findings suggested the gender paradox that the proportion of self-inflicted deaths was higher among men than women, while the proportion of non-fatal self-inflicted injuries was higher among women than among men, particularly in the group aged <=49 years. Our findings showing the importance of the prevention for self-inflicted injuries as well as the gender paradox of self-inflicted injuries will provide important epidemiological information to improve psychiatric cares in prehospital emergency settings.

CONCLUSIONS:

In the total population, the annual incidence of self-inflicted injuries responded to by EMS personnel was higher among women than among men. However, the proportion of self-inflicted deaths was greater among men than women, and the most frequent manner among deceased patients was by hanging.

KEYWORDS:

Emergency medical service; Epidemiology; Population-based study; Self-inflicted injuries

PMID:
27170115
PMCID:
PMC4864919
DOI:
10.1186/s13049-016-0261-0
[Indexed for MEDLINE]
Free PMC Article

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