Abstract
Background 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. Method 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. Results 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). Conclusion 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.
| Original language | English |
|---|---|
| Pages (from-to) | 184-194 |
| Number of pages | 11 |
| Journal | Injury |
| Volume | 48 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Jan 2017 |
Keywords
- Deliberate self-harm
- Functional
- Return to work (RTW)
- Trauma
Cite this
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Mortality, functional and return to work outcomes of major trauma patients injured from deliberate self-harm. / Nguyen, Tu Q; Simpson, Pamela M; Braaf, Sandra C; Gabbe, Belinda J.
In: Injury, Vol. 48, No. 1, 01.01.2017, p. 184-194.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Mortality, functional and return to work outcomes of major trauma patients injured from deliberate self-harm
AU - Nguyen, Tu Q
AU - Simpson, Pamela M
AU - Braaf, Sandra C
AU - Gabbe, Belinda J
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background 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. Method 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. Results 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). Conclusion 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.
AB - Background 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. Method 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. Results 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). Conclusion 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.
KW - Deliberate self-harm
KW - Functional
KW - Return to work (RTW)
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=85006319404&partnerID=8YFLogxK
U2 - 10.1016/j.injury.2016.10.038
DO - 10.1016/j.injury.2016.10.038
M3 - Article
VL - 48
SP - 184
EP - 194
JO - Injury
JF - Injury
SN - 0020-1383
IS - 1
ER -