Non-suicidal deaths following hospital-treated self-poisoning

Abstract

Patients who present with self-poisoning have increased mortality from accidental and 'natural' causes. Long-term treatment goals for these patients need to address non-suicide mortality in addition to suicide mortality.

Shared characteristics of suicides and other unnatural deaths following non-fatal self-harm? A multicentre study of risk factors

“…Previous investigations of non-suicide deaths following self-poisoning found little overlap between risk factors for accidents and death by natural causes (Carter et al 2005). Others had study populations too small to identify factors for accidental death alone (Owens et al 2005; Karasouli et al 2010).…”

“…We have focused on individuals' self-harm more proximate to their death than is standard practice. Studies of risk factors for suicide have generally used the first episode of self-harm in the study period (‘index episode’) to identify individuals involved, who are then followed up for a further time period with respect to mortality (Hall et al 1998; Ostamo & Lönnqvist, 2001; Hawton et al 2003 b , 2007; Carter et al 2005; Antretter et al 2009; Karasouli et al 2010). Risk factors in these studies were determined from exposure variables at the index episode, that is an arbitrary point in time, not necessarily the first-ever episode for the individual.…”

Characteristics of medication overdose presentations to the ED: how do they differ from illicit drug overdose and self-harm cases?

“…Conservative estimates of repeat presentation to hospital suggest rates of between 12% and 19% within 12 weeks to 2 years 7 11 13 20 24 25. Individuals with a history of self-poisoning have a greater probability of eventual death by suicide than the general population 26 27. In spite of this, those who attend repeatedly for medication overdose are treated less urgently and have shorter stays 7…”

A feasible method for linkage studies avoiding clerical review: linkage of the national HIV/AIDS surveillance databases with the National Death Index in Australia

“…Several studies in the United States (US) and Australia have involved linkage with the NDI to establish whether the death occurred and cause of death. [3][4][5][6][7][8][9][10][11] The usual method of linkage uses probabilistic software programs that assign Methods Article each possible match a weight indicative of the likelihood that a match is a true one. Clear matches and non-matches can generally be established for many cases, but there often follows a timeconsuming and subjective clerical review of cases for where it is not immediately clear whether the linkage match is a true one.…”