Mortality, functional and return to work outcomes of major trauma patients injured from deliberate self-harm

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• 作者：Tu Q Nguyen^a ; ^{tu.nguyen@monash.edu} ; Pamela M Simpson^a ; ^{pamela.simpson@monash.edu} ; Sandra C Braaf^a ; ^{sandra.braaf@monash.edu} ; Belinda J Gabbe^a ; ^b ; ^{belinda.gabbe@monash.edu}
• 关键词：Deliberate self-harm ; Trauma ; Functional ; Return to work (RTW)
• 刊名：Injury
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：48
• 期：1
• 页码：184-194
• 全文大小：411 K
• 卷排序：48

文摘

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.Method482 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.ResultsA 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).ConclusionThe 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.