Top

European Journal of Trauma and Emergency Surgery

Published in:

01-02-2012 | Original Article

Multiple blunt trauma after suicidal attempt: an analysis of 4,754 multiple severely injured patients

Authors: T. Topp, T. Müller, I. Kiriazidis, R. Lefering, S. Ruchholtz, C. A. Kühne, Trauma Registry of the German Trauma Society

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2012

Abstract

Purpose

The suicidal attempt is a significant cause for multiple severe injuries in Germany. The aim of the present study was to obtain information regarding injury patterns, clinical treatment, and outcome.

Methods

We analyzed the data of 4,754 patients of the Trauma Registry of the German Trauma Society (1993–2007) with an Injury Severity Score (ISS) ≥9 after a suicidal jump from a height (SUICIDE) and after an accidental fall from a height (ACCIDENT).

Results

Comparing the data of 3,682 patients with accidental fall versus those with intentional fall/jump (n = 1,072), we found that male patients were predominant in the ACCIDENT group (84.9 vs. 52.2%). The SUICIDE group had more severe injuries (ISS: 31.8 vs. 26.4). The ACCIDENT group suffered more severe head injuries (51.1 vs. 36.6%). Mortality (21.4 vs. 14.2%), length of stay in hospital (29.5 vs. 26.5 days), and costs (€34,833 vs. €24,701) were higher in the SUICIDE group.

Conclusions

Falls from a height are a common cause of injury among severely injured patients. The resulting trauma composes a particular form of blunt trauma with severe and multiple injuries, which depends on the fact of whether the free fall from a height was caused by an accident or as a result of a suicidal attempt. Taking the injury severity into consideration, there is no difference in the prognosis of the patients.

Kühne CA, Ruchholtz S, Buschmann C, Sturm J, Lackner CK, Wentzensen A, Bouillon B, Waydhas C, Weber C; AG Polytrauma DGU. Trauma centers in Germany. Status report. Unfallchirurg. 2006;109:357–66.PubMedCrossRef

Liener UC, Rapp U, Lampl L, Helm M, Richter G, Gaus M, Wildner M, Kinzl L, Gebhard F. Incidence of severe injuries. Results of a population-based analysis. Unfallchirurg. 2004;107:483–90.PubMedCrossRef

Juhra C, Franz D, Roeder N, Vordemvenne T, Raschke MJ. Classification of severely injured patients in the G-DRG System 2008. Unfallchirurg. 2009;112:525–32.PubMedCrossRef

Statistisches Bundesamt Deutschland (2007).

Schmidtke A, Bille-Brahe U, DeLeo D, Kerkhof A, Bjerke T, Crepet P, Haring C, Hawton K, Lönnqvist J, Michel K, Pommereau X, Querejeta I, Phillipe I, Salander-Renberg E, Temesváry B, Wasserman D, Fricke S, Weinacker B, Sampaio-Faria JG. Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989–1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand. 1996;93:327–38.PubMedCrossRef

Hadjizacharia P, Brown CV, Teixeira PG, Chan LS, Yang K, Salim A, Inaba K, Rhee P, Demetriades D. Traumatic suicide attempts at a level I trauma center. J Emerg Med. 2010;39:411–8PubMedCrossRef

Richter D, Hahn MP, Ostermann PA, Ekkernkamp A, Muhr G. Vertical deceleration injuries: a comparative study of the injury patterns of 101 patients after accidental and intentional high falls. Injury. 1996;27:655–9.PubMedCrossRef

Teh J, Firth M, Sharma A, Wilson A, Reznek R, Chan O. Jumpers and fallers: a comparison of the distribution of skeletal injury. Clin Radiol. 2003;58:482–6.PubMedCrossRef

Ruchholtz S. The Trauma Registry of the German Society of Trauma Surgery as a basis for interclinical quality management. A multicenter study of the German Society of Trauma Surgery. Unfallchirurg. 2000;103:30–7.PubMedCrossRef

10.

Lefering R. Development and validation of the Revised Injury Severity Classification score for severely injured patients. Eur J Trauma Emerg Surg. 2009;35:437–47.CrossRef

11.

Pape HC, Grotz M, Schwermann T, Ruchholtz S, Lefering R, Rieger M, Tröger M, Graf von der Schulenburg JM, Krettek C; AG Polytrauma der DGU. The development of a model to calculate the cost of care for the severely injured—an initiative of the Trauma Register of the DGU. Unfallchirurg. 2003;106:348–57.PubMedCrossRef

12.

Böstman OM. Suicidal attempts by jumping from heights. A three-year prospective study of patients admitted to an urban university accident department. Scand J Soc Med. 1987;15:119–203.PubMed

13.

Etzersdorfer E, Voracek M, Kapusta N, Sonneck G. Epidemiology of suicide in Austria 1990–2000: general decrease, but increased suicide risk for old men. Wien Klin Wochenschr. 2005;117:31–5.PubMedCrossRef

14.

Dzupa V, Chmelová J, Pavelka T, Obruba P, Wendsche P, Simko P. Multicentric study of patients with pelvic injury: basic analysis of the study group. Acta Chir Orthop Traumatol Cech. 2009;76:404–9.PubMed

15.

Isbister ES, Roberts JA. Autokabalesis: a study of intentional vertical deceleration injuries. Injury. 1992;23:119–22.PubMedCrossRef

16.

Mathis RD, Levine SH, Phifer S. An analysis of accidental free falls from a height: the ‘spring break’ syndrome. J Trauma. 1993;34:123–6.PubMedCrossRef

17.

Aufmkolk M, Majetschak M, Voggenreiter G, Obertacke U, Schmit-Neuerburg KP. Follow-up and prognosis of severe accidental trauma in the aged. Unfallchirurg. 1997;100:477–82.PubMedCrossRef

18.

Katz K, Gonen N, Goldberg I, Mizrahi J, Radwan M, Yosipovitch Z. Injuries in attempted suicide by jumping from a height. Injury. 1988;19:371–4.PubMedCrossRef

19.

Ruchholtz S, Nast-Kolb D, Waydhas C, Schweiberer L. The injury pattern in polytrauma. Value of information regarding accident process in clinical acute management. Unfallchirurg. 1996;99:633–41.PubMedCrossRef

20.

Ruchholtz S, Pajonk FG, Waydhas C, Lewan U, Nast-Kolb D, Schweiberer L. Long-term results and quality of life after parasuicidal multiple blunt trauma. Crit Care Med. 1999;27:522–30.PubMedCrossRef

21.

Warner KG, Demling RH. The pathophysiology of free-fall injury. Ann Emerg Med. 1986;15:1088–93.PubMedCrossRef

22.

Schmelz A, Ziegler D, Beck A, Kinzl L, Gebhard F. Costs for acute, stationary treatment of polytrauma patients. Unfallchirurg. 2002;105:1043–8.PubMedCrossRef

23.

Schwermann T, Grotz M, Blanke M, Ruchholtz S, Lefering R, V d Schulenburg JM, Krettek C, Pape HC. Evaluation of costs incurred for patients with multiple trauma particularly from the perspective of the hospital. Unfallchirurg. 2004;107:563–74.PubMedCrossRef

Title: Multiple blunt trauma after suicidal attempt: an analysis of 4,754 multiple severely injured patients
Authors: T. Topp
T. Müller
I. Kiriazidis
R. Lefering
S. Ruchholtz
C. A. Kühne
Trauma Registry of the German Trauma Society
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: European Journal of Trauma and Emergency Surgery / Issue 1/2012
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-011-0114-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Multiple blunt trauma after suicidal attempt: an analysis of 4,754 multiple severely injured patients

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2012

Trauma registries in Europe

Biomechanical comparison of two locking plate systems for the distal tibia

Pediatric fractures: temporal trends and cost implications of treatment under general anesthesia

Evaluating the effects of immediate application of negative pressure therapy after decompression from abdominal compartment syndrome in an experimental porcine model

Epidemiology of in-hospital trauma deaths

Gastrointestinal tract perforation following blunt abdominal trauma: an institution’s experience