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049 Suicide ideation and intentional self-harm as a risk factor following a trauma alert
  1. Etienne Pracht1,
  2. Christopher Snyder2,
  3. Athanasios Tsalatsanis1,
  4. Christina Eldredge1,
  5. Amber Mehmood1,
  6. Kathleen Pracht3,
  7. Richa Phuel1
  1. 1University of South Florida, Tampa, USA
  2. 2Johns Hopkins All Children’s Hospital, St Petersburg, USA
  3. 3Providence Pass, St. Cloud, USA


Statement of Purpose The causes of suicide attempts or ideation are complex and multifaceted. This study analyzes physical traumatic injury as a risk factor for suicide ideation and intentional self-harm.

Methods/Approach A retrospective analysis of an all-inclusive inpatient dataset, comparing the one-year hospital readmission rate, involving intentional self-harm or suicide ideation, of two groups of injured patients: (a) those classified as trauma alerts (TAs) at a Level I or II trauma center or (b) individuals who were treated as emergencies without activation (EMWA) of trauma services. We compared readmission rates (per 1000) of TAs and EMWAs using t-tests. Logistic regression further examined the probability of readmission with suicide ideation or intentional self-harm, controlling for patient demographics, pre-existing mental health conditions, injury type, and socioeconomic status.

Results Rates of readmission with intentional self-harm and suicide ideation were, on average, 60 and 45 percent higher for the TA compared to the EMWA patient group (P < 0.001). Compared to the population at large, the post-trauma hospitalization rate for self-harm and suicide ideation was, respectively, 8.7 and 7.6 times greater (P < 0.001). Over 80% of patients readmitted with intentional self-harm or suicide ideation had a pre-existing mental health condition. Logistic regression results indicate these patients had an odds-ratio of near six, predicting the readmission. Examining the subset of patients without a documented history of a mental health condition, trauma alert patients were significantly more likely to commit initial and intentional self-harm (OR=1.26, 95% CI 1.03–1.53) or develop suicide ideation (OR=1.28, 95% CI 1.08–1.42), diagnosed during an inpatient readmission within one year of the signature event. Gender, race, insurance status, socioeconomic status, and injury type were also significant.

Conclusions There is a significant difference between trauma alerts versus emergencies without trauma services as it pertains to the post-hospitalization development of suicide ideation or engagement in intentional self-harm.

Significance Mental health support must be made available to survivors of major trauma, particularly those with a preexisting mental health condition and traumatic brain injury.

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