Increase in Emergency Department Visits for Self-Inflicted Injuries Among Youth

Summary and Comment |
June 15, 2015

Increase in Emergency Department Visits for Self-Inflicted Injuries Among Youth

  1. Katherine Bakes, MD

Adolescent trauma patients with self-inflicted injuries were more likely to have alcoholism, to be obese, and to die from their injuries.

  1. Katherine Bakes, MD

Investigators reviewed data from the National Trauma Data Bank to identify characteristics of adolescents (10–18 years of age) who presented with self-inflicted injuries to more than 700 trauma centers from 2009 to 2012. Of about 290,000 adolescent trauma patients, 72% were male, 60% were white, and 60% were aged 15–18 years.

Overall, 3664 patients (1.3%) had self-inflicted injuries. Of these, 5% had mental health diagnoses, mostly depressive disorders. The most common methods of self-injury were cuts (more likely in females) and firearm injuries (more likely in males). Patients 10 to 14 years of age were more likely than older patients to self-injure through suffocation (15% vs. 8%).

Self-inflicted injuries increased over the 4-year study period, from 1.1% to 1.6% of adolescent trauma visits. Compared with adolescent trauma patients without self-injury, those with self-injury were more likely to have alcoholism (2% vs. 4%) and obesity (1% vs. 2%) and were more likely to die from their injury (1% vs. 4%). Factors associated with increased odds of self-inflicted injury included age 15–18 years (odds ratio, 2.7), presence of a comorbid condition (OR, 1.6), public insurance (OR, 1.4); female sex (odds ratio, 1.4); and self-pay insurance status (OR, 1.2). Odds of death from a self-inflicted injury were lower for females (OR, 0.4) and Hispanics (OR, 0.6), but higher for those with an injury severity score ≥16 (OR, 28) and self-pay status (OR, 2.2).

Comment

Just as we have learned for patients addicted to alcohol, victims of domestic abuse, and those with other social ills, emergency department visits provide an opportunity to intervene for youth at high risk for violence. This study helps providers target interventions to teens who may be at increased risk for self-harm and suicide.

Editor Disclosures at Time of Publication

  • Disclosures for Katherine Bakes, MD at time of publication Grant / Research support Department of Justice Editorial boards Emergency Medicine Secrets (Elsevier)

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