Self-harm surveillance: an analysis of ICD-10-CM code R45.88, non-suicidal self-harm, with no co-occurring injury...

Area of Science:

• Public Health Surveillance
• Medical Coding Accuracy
• Mental Health Research

Background:

• Lack of uniform guidance on classifying non-suicidal self-harm (ICD-10-CM code R45.88) cases, with or without concurrent injury.
• Need to understand demographic and clinical differences between self-harm cases with and without associated injuries.

Purpose of the Study:

• To compare patients with self-harm and co-occurring injury versus those with self-harm but no injury.
• To analyze differences in demographics and comorbidities between these two self-harm case classifications.

Main Methods:

• Analysis of Wisconsin and Oregon discharge records (2022-2023).
• Creation of two groups: Group A (self-harm with injury code) and Group B (R45.88 without other injury codes).
• Univariate and logistic regression analyses for hospital and emergency department patients.

Main Results:

• Group B patients (self-harm without injury) were significantly younger across both jurisdictions and patient types.
• Age remained a significant factor in logistic regression models for both hospital and ED patients.
• Significant differences in comorbidities (e.g., suicidal ideation, mental health disorders) and demographics were observed between groups, varying by jurisdiction.

Conclusions:

• Inclusive surveillance of self-harm, incorporating all R45.88 instances regardless of injury, provides a more accurate representation of self-harm burden.
• This approach better identifies and characterizes the populations impacted by various forms of self-harm behavior.