Sex-related differences in childhood and adolescent self-inflicted injuries: a National Trauma Databank review

Branco, Bernardino C.; Inaba, Kenji; Barmparas, Galinos; Talving, Peep; David, Jean-Stéphane; Plurad, David; Green, Donald J.; Δημητριάδης, Δημήτριος

doi:10.1016/j.jpedsurg.2009.08.006

Cited by 9 publications

(8 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although multiple studies have highlighted that rates of SII are increasing in both adolescents and adults, 4,5 this study represents the most current analysis in an adolescent population. Our finding that cut/pierce was the most common mechanism differs from an earlier study using data from the NTDB 6 and may indicate a shift in self-harm behavior in youth.…”

Section: Discussioncontrasting

confidence: 99%

“…[6][7][8] Similar to our findings, female youth have been shown to be more likely to visit the ED for SII injuries compared with males, 7,8 but males have been shown to have a greater risk of dying from their injuries, likely because they tend to use more lethal mechanisms such as firearms. 6,7 Adolescents with any comorbid condition were at increased risk of SII in our study, and those with $2 comorbid conditions had nearly 3 times the odds, findings that may warrant increased attempts at prevention in these young people. We also found that the specific comorbid conditions of obesity and alcoholism were associated with increased risk of an SII, results that align with other research on selfharm behavior in adolescents.…”

Section: Figuresupporting

confidence: 84%

“…Branco et al analyzed data from the NTDB, years 2002 to 2006, and still found poisoning to be the most common method in females even with the limited reporting of this SII. 6 Because there has been no change in documentation of poisoning cases since the NTDB started collecting data, a comparison of our results regarding rates of ED visits for poisoning to the results of Branco et al may reflect a decrease in selfinjury through poisoning in adolescents. A much higher percentage of adolescents visited the ED for cut/pierce injuries in our cohort compared with Branco et al, which may reflect a rise in selfmutilation behavior in adolescents.…”

Section: Figurementioning

confidence: 55%

“…5 Although research has shown changing patterns in self-harm, the majority of studies examining ED visits for SII in adolescents have examined data from 2008 or earlier. 4,[6][7][8][9][10] For primary and secondary prevention, it is vital to have the most recent information possible to most accurately describe the current epidemiology of self-harm behavior in youth.…”

Section: What This Study Addsmentioning

confidence: 99%

“…SIIs were defined as cut/ pierce (E956), firearm (E955.0 to E955. 4 6 Therefore, we decided to include all available data on self-inflicted poisonings in our analysis, even though incomplete, to examine changes in SII trends over time within the NTDB.…”

Section: Self-inflicted Injurymentioning

confidence: 99%

See 4 more Smart Citations

Emergency Department Visits for Self-Inflicted Injuries in Adolescents

Cutler¹,

Flood

Dreyfus

et al. 2015

Pediatrics

View full text Add to dashboard Cite

OBJECTIVES: To describe emergency department (ED) visits for self-inflicted injury (SII) among adolescents, examine trends in SII mechanisms, and identify factors associated with increased risk.METHODS: Analyses included patients aged 10 to 18 years from the National Trauma Data Bank, years 2009 to 2012. We used Cochran-Armitage trend tests to examine change over time and generalized linear models to identify risk factors for SII. RESULTS:We examined 286 678 adolescent trauma patients, 3664 (1.3%) of whom sustained an SII. ED visits for SII increased from 2009 to 2012 (1.1% to 1.6%, P for trend # .001), whereas selfinflicted firearm visits decreased (27.3% to 21.9%, P for trend = .02). The most common mechanism in males was firearm (34.4%), and in females, cut/pierce (48.0%). Odds of SII were higher in females (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.13-1.77), older adolescents (OR 2.73, 95% CI 2.38-3.14), adolescents with comorbid conditions (OR 1.64; 95% CI 1.49-1.80), and Asian adolescents (OR 1.67, 95% CI 1.35-2.08) and lower in African American adolescents (OR 0.78, 95% CI 0.70-0.87). Adolescents in the public or self-pay insurance category had higher odds of SII (OR 1.44, 95% CI 1.27-1.64) than those in the private insurance category (OR 1.15, 95% CI 1.01-1.31). Adolescents with an SII had higher odds of death than those with other injuries (OR 12.9, 95% CI 6.78-24.6). CONCLUSIONS:We found a significant increase in the number of SIIs by adolescents that resulted in ED visits from 2009 to 2012. Although SIIs increased, we found a significant decrease in the percentage of adolescents who self-injured with a firearm. SIIs reflect a small percentage of ED visits, but these patients have dramatically higher odds of death.WHAT'S KNOWN ON THIS SUBJECT: Self-harm behavior is a major public health problem and a leading cause of death in adolescents. The majority of patients who self-injure do not die, but they are at increased risk for a successful future suicide attempt.WHAT THIS STUDY ADDS: Emergency department visits for self-inflicted injuries in adolescents increased from 2009 to 2012, whereas visits for self-inflicted firearm injuries decreased. The presence of any comorbid condition increased risk for self-harm, indicating that increased attempts at prevention may be warranted in these young people.

show abstract

Section: Discussioncontrasting

confidence: 99%