Re-presentation and suicide rates in emergency department patients who self-harm.
OBJECTIVE
To investigate adult presentations to North Shore Hospital, Auckland, New Zealand, following deliberate self-harm, determine re-presentation and suicide rates and investigate the characteristics of those patients who re-present.


METHODS
Retrospective review of a cohort of adult patients presenting to North Shore Hospital Emergency Care Centre in Auckland, New Zealand, with deliberate self-harm between 1 January 2001 and 31 August 2002, using data from the National Minimum Data Set and Hospital Discharge Database. The re-presentation rate was calculated as the percentage of patients presenting a second time within 1 year of their index presentation. The suicide rate was calculated as the percentage of patients with a coroner's verdict of suicide within 1 year of their index presentation of deliberate self-harm.


RESULTS
There were 1055 presentations by 754 people during the presentation period. Of these 754 people, 136 presented for a second time within a year of the index case (136/754 [18.0%, 95% CI 15.5-21.0]). Eight of the seven hundred and fifty-four people went on to commit suicide within 1 year (8/754 [1.1%, 95% CI 0.5-2.1]). Self-poisoning was the most common method of self-harm. Minor tranquillizers were used more commonly in the group who re-presented.


CONCLUSIONS
Re-presentation and suicide rates in our study were similar to previously published rates. Further research is needed to identify strategies to reduce re-presentations and excess mortality in all people who deliberately self-harm.
Howson
Mark A
MA
Emergency Care Centre, North Shore Hospital, Takapuna, Auckland, New Zealand. mark.howson@doctors.org.uk
Yates
Kim M
KM
Hatcher
Simon
S
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016001:Confidence Intervals; D062787:Drug Overdose / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012652:Self Mutilation / Q000453:epidemiology; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000453:epidemiology*; D017678:Sex Distribution; D013405:Suicide / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D015996:Survival Rate; D055815:Young Adult