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Mortality, functional and return to work outcomes of major trauma patients injured from deliberate self-harm.
- Source :
-
Injury . Jan2017, Vol. 48 Issue 1, p184-194. 11p. - Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>Self-harm and intentional injuries represent a significant public health concern. People who survive serious injury from self-harm can experience poor outcomes that negatively impact on their daily life. The aim of this study was to investigate a cohort of major trauma patients hospitalised for self-harm in Victoria, and to identify risk factors for longer term mortality, functional recovery and return to work.<bold>Method: </bold>482 adult major trauma patients who were injured due to self-harm and survived to hospital discharge, and were captured by the population-based Victorian State Trauma Registry (VSTR), were included. For those with a date of injury from January 1, 2007 to December 31, 2013, demographics and injury event data, Glasgow Outcome Scale Extended (GOS-E) and return to work (RTW) outcomes at 6, 12 and 24 months post-injury were extracted from the registry. Post-discharge mortality was identified through the Victorian Registry of Births, Deaths and Marriages (BDM). Multivariable logistic regression was used to determine predictors of the GOS-E and RTW and survival analysis was used to identify predictors of mortality.<bold>Results: </bold>A total of 37 (7.7%) deaths occurred post-discharge. There were no clear predictors of all-cause mortality. Overall, 36% of patients reported making a good recovery at 24 months. Older age (p=0.01), transport-related methods of self-harm (p=0.02), higher Injury Severity Score (p<0.001) and having a Charlson Comorbidity Index weighting of one or more (p=0.02) were predictive of poorer functional recovery. Of patients who were working or studying prior to injury, 54% reported returning to work by 24 months post-injury. Higher Injury Severity Score was an important predictor of not returning to work (p=0.002).<bold>Conclusion: </bold>The vast majority of major trauma patients who self-harmed and survived to hospital discharge were alive at two years post-injury, yet only half of this cohort returned to work and just over a third of patients experienced a good recovery. [ABSTRACT FROM AUTHOR]
- Subjects :
- *WOUNDS & injuries
*SELF-mutilation
*PUBLIC health
*TRAUMA centers
*HOSPITAL admission & discharge
*PATIENTS
*MENTAL health
*CONVALESCENCE
*EMPLOYMENT reentry
*SELF-injurious behavior
*SURVIVAL analysis (Biometry)
*DISCHARGE planning
*ACQUISITION of data
*DISEASE prevalence
*TRAUMA severity indices
*PSYCHOLOGICAL factors
Subjects
Details
- Language :
- English
- ISSN :
- 00201383
- Volume :
- 48
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Injury
- Publication Type :
- Academic Journal
- Accession number :
- 120409094
- Full Text :
- https://doi.org/10.1016/j.injury.2016.10.038