Traumatic suicide attempts at a level I trauma center

Area of Science:

• Trauma Surgery
• Public Health
• Epidemiology

Background:

• Traumatic suicide attempts (TSA) represent a significant public health concern.
• Understanding demographic and mechanistic factors is crucial for prevention and intervention.

Purpose of the Study:

• To characterize traumatic suicide attempts (TSA) based on age, gender, race, and mechanism of injury.
• To identify demographic and injury-related factors associated with TSA outcomes.

Main Methods:

• Retrospective review of 876 TSA patients admitted to a level I trauma center (1992-2005).
• Classification of mechanisms: jump from height, firearm (gunshot wound [GSW]), cutting/piercing (stab wound [SW]), and motor vehicle (MV)-related.
• Age categorization: <18, 18-35, 36-54, 55-69, ≥70 years.

Main Results:

• Most TSA patients were male (83%) with a mean age of 35. Stab wounds (SW) were the most common mechanism (39%), followed by jump (26%), GSW (21%), and MV-related (13%).
• Mechanism varied significantly by age (p < 0.0001); GSW predominated in patients <18 (64%) and ≥70 (44%), while SW was most common in other age groups.
• Overall TSA success rate was 16%. Mortality was significantly higher in the 70+ age group (AOR 12.4) and for GSW compared to SW (AOR 9.8).

Conclusions:

• Stab wounds are the most frequent mechanism for TSA, but gunshot wounds (GSW) are the most lethal.
• Age is a critical factor influencing the choice of suicide attempt mechanism, with firearms preferred by the youngest and oldest demographics.
• Both age and the method employed in a TSA are significant determinants of its success and mortality.