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2016 ; 24
(ä): 68
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Characteristics and outcomes of emergency patients with self-inflicted injuries:
a report from ambulance records in Osaka City, Japan
#MMPMID27170115
Matsuyama T
; Kitamura T
; Kiyohara K
; Hayashida S
; Kawamura T
; Iwami T
; Ohta B
Scand J Trauma Resusc Emerg Med
2016[May]; 24
(ä): 68
PMID27170115
show ga
BACKGROUND: Few studies have evaluated the actual situations of emergency
patients with self-inflicted injuries treated by emergency-medical-service (EMS)
personnel. METHODS: This study retrospectively reviewed population-based
ambulance records in Osaka City, Japan, between January 2010 and December 2012,
and enrolled emergency patients who suffered from self-inflicted injuries such as
poisoning by drugs or gas, cutting/piercing skin, jumping from heights, hanging,
and drowning. The endpoint was the annual incidence per 100,000 populations in
Osaka City of emergency patients who presented with self-inflicted injuries by
age and sex. Their outcomes including deaths at the scene and hospital arrival
were also evaluated. RESULTS: During the study period, a total of 8,671 patients
with 9,424 incidents of self-inflicted injuries were documented. The annual
incidence of self-inflicted injuries was higher among women than men in the whole
population and in the age group?=49 years (136.9 versus 82.6, and 214.8 versus
93.3, both Ps?0.001), but it was inversely lower among women in the age
group?>?=50 years (49.0 versus 68.9, P?0.001). The total number of
self-inflicted deaths was 1,564 (16.6 %), and the overall proportion of
self-inflicted deaths was greater among men than women (32.2 % [1075/3340] vs.
7.5 % [451/6027], P?0.001). The proportion of self-inflicted hanging was 76.7 %
[1142/1489], followed by poisoning by carbon monoxide at 57.1 % [56/98] and
jumping to death at 47.6 % [254/534]. DISCUSSION: Using large-scale EMS records,
we investigated characteristics and outcomes of emergency patients with
self-inflicted injuries treated by EMS personnel. Our findings suggested the
gender paradox that the proportion of self-inflicted deaths was higher among men
than women, while the proportion of non-fatal self-inflicted injuries was higher
among women than among men, particularly in the group aged <=49 years. Our
findings showing the importance of the prevention for self-inflicted injuries as
well as the gender paradox of self-inflicted injuries will provide important
epidemiological information to improve psychiatric cares in prehospital emergency
settings. CONCLUSIONS: In the total population, the annual incidence of
self-inflicted injuries responded to by EMS personnel was higher among women than
among men. However, the proportion of self-inflicted deaths was greater among men
than women, and the most frequent manner among deceased patients was by hanging.