Long-term follow-up after severe suicide attempt by multiple blunt trauma

Pajonk, Frank-Gerald B.; Ruchholtz, Steffen; Waydhas, Christian; Schneider‐Axmann, Thomas

doi:10.1016/j.eurpsy.2004.10.003

Cited by 24 publications

(29 citation statements)

References 21 publications

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“…One group of investigators has shown that the involvement of the psychiatry team early in the course of a self-injured patient's hospitalization, including regular visits from the attending psychiatrist, can minimize the incidence of future suicide attempts in those patients who survive hospitalization. 28 In conclusion, our study shows that risk-adjusted mortality in patients treated for self-inflicted injury is significantly higher than in assault victims or patients who sustain unintentional injury. Furthermore, patients who survive selfinflicted injury also appear to utilize a comparatively high level of healthcare resources.…”

Section: Discussionmentioning

confidence: 56%

Does Intent Matter? The Medical and Societal Burden of Self-Inflicted Injury

Bennett

Vaslef

Shapiro

et al. 2009

Journal of Trauma: Injury, Infection &Amp; Critical Care

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Section: Discussionmentioning

confidence: 56%

Does Intent Matter? The Medical and Societal Burden of Self-Inflicted Injury

Bennett

Vaslef

Shapiro

et al. 2009

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…Although the fact that the reattempted suicide rate in trauma patients in this study is low, some studies reported a high risk of reattempts after parasuicide [26] and some reported low. Pajonk et al describes a relatively low reattempted suicide rate after severe suicide attempts [27]. All five patients who died within 30 days after admission were above the age of 75 and died of complications.…”

Section: Discussionmentioning

confidence: 99%

A mixed psychiatric and somatic care unit for trauma patients: 10 years of experience in an urban level I trauma center in the Netherlands

Dekker

Heller

Meij

et al. 2019

Eur J Trauma Emerg Surg

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Background A medical-psychiatric unit (MPU) is a special ward where staff is trained in caring for patients with psychiatric or behavioural problems that need hospitalisation for physical health problems. It is well known that these patients are at higher risk of complications and have a longer length of stay resulting in higher costs than patients without psychiatric comorbidity. The objective of this study was to analyse the trauma patient population of the first 10 years of existence of the MPU in a level I trauma center. Patients and methods A retrospective analysis was performed in 2-year cohorts from 2006 to 2016. All trauma patients admitted to the MPU were compared with the overall trauma patient population in VUmc. Data (psychiatric diagnosis, substance abuse, trauma scores, surgical interventions, complications, mortality) were extracted from individual patient notes and the Regional Trauma Registry. Results 258 patients were identified. 36% of all patients had a history of previous psychiatric admission and 30% had attempted suicide at least once in their lifetime. Substance abuse was the most common psychiatric diagnosis (39%), with psychotic disorder (28%) in second place. The median hospital stay was 21 days. Median MPU length of stay was 10 days (range 1-160). Injuries were self-inflicted in 57%. The most common mechanism of injury was fall from height with intentional jumping in second place. Penetrating injury rate was 24% and 33% had an ISS ≥ 16, compared to 5% and 15%, respectively, in the overall trauma patient population. The most common injuries were those of the head and neck. Complication rate was 49%. Conclusion Trauma patients that were admitted to the MPU of an urban level I trauma center had serious psychiatric comorbidity as well as high injury severity. Penetrating injury was much more common than in the overall trauma patient population. A high complication rate was noted. The high psychiatric comorbidity and the complicated care warrants combined psychiatric and somatic (nursing) care for this subpopulation of trauma patients. This should be taken into account in the prehospital triage to a trauma center. The institution of a MPU in level I trauma centers is recommended.

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“…5 Apart from death by suicide, suicide attempts are also markers for subsequent persistent physical and mental health issues, repeat suicide attempt, psychiatric hospitalisations, impaired academic performance, unemployment, partner abuse victimisation and perpetration, having children removed by social services, loneliness, relationship difficulties, impaired social functioning and low life satisfaction. [6][7][8][9][10][11] Despite the considerable burden that suicide attempts represent in our society, there is a lack of reliable surveillance data on suicide attempts that could inform public health action. 12 This is in contrast with actual suicide rates, that are increasingly monitored in many countries worldwide.…”

Section: Open Accessmentioning

confidence: 99%

Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case–control study of suicide attempts in Catalonia, Spain

et al. 2020

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IntroductionSuicide attempts represent an important public health burden. Centralised electronic health record (EHR) systems have high potential to provide suicide attempt surveillance, to inform public health action aimed at reducing risk for suicide attempt in the population, and to provide data-driven clinical decision support for suicide risk assessment across healthcare settings. To exploit this potential, we designed the Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study. Using centralised EHR data from the entire public healthcare system of Catalonia, Spain, the CSRC-Epi study aims to estimate reliable suicide attempt incidence rates, identify suicide attempt risk factors and develop validated suicide attempt risk prediction tools.Methods and analysisThe CSRC-Epi study is registry-based study, specifically, a two-stage exposure-enriched nested case–control study of suicide attempts during the period 2014–2019 in Catalonia, Spain. The primary study outcome consists of first and repeat attempts during the observation period. Cases will come from a case register linked to a suicide attempt surveillance programme, which offers in-depth psychiatric evaluations to all Catalan residents who present to clinical care with any suspected risk for suicide. Predictor variables will come from centralised EHR systems representing all relevant healthcare settings. The study’s sampling frame will be constructed using population-representative administrative lists of Catalan residents. Inverse probability weights will restore representativeness of the original population. Analysis will include the calculation of age-standardised and sex-standardised suicide attempt incidence rates. Logistic regression will identify suicide attempt risk factors on the individual level (ie, relative risk) and the population level (ie, population attributable risk proportions). Machine learning techniques will be used to develop suicide attempt risk prediction tools.Ethics and disseminationThis protocol is approved by the Parc de Salut Mar Clinical Research Ethics Committee (2017/7431/I). Dissemination will include peer-reviewed scientific publications, scientific reports for hospital and government authorities, and updated clinical guidelines.Trial registration numberNCT04235127.

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Long-term follow-up after severe suicide attempt by multiple blunt trauma

Abstract: Despite the seriousness of the suicide attempt, survivors recovered well in about half the cases with no further suicide attempt in any patient. An early psychiatric consultation already on the Intensive Care Unit (ICU) is recommended.

Cited by 24 publications

References 21 publications

Does Intent Matter? The Medical and Societal Burden of Self-Inflicted Injury

Does Intent Matter? The Medical and Societal Burden of Self-Inflicted Injury

A mixed psychiatric and somatic care unit for trauma patients: 10 years of experience in an urban level I trauma center in the Netherlands

Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case–control study of suicide attempts in Catalonia, Spain

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