Abstract
BackgroundSelf-inflicted injury is a leading cause of death worldwide. It is hypothesized that due to instincts for self-preservation, the severity of abdominal injury would be decreased following suicidal self-stabbing in comparison to stab wounds from assault, and therefore a more conservative management might be considered. MethodsAll patients with isolated abdominal stab wound (SW) admitted to 19 Trauma Centers in Israel between the years 1997 and 2018 were included in the study. Patients with self-inflicted abdominal SW (Group I) were compared to victims with abdominal SW following assault (Group II). ResultsGroup I included 9.4% (314/3324) of patients eligible for this study. Compared to Group II, Group I patients were older (median: 39 years, IQR 28,52 vs. 24 years, IQR 19,33; p<0.001), had more females (28.7% vs 4.9%, p <0.001), had longer length of hospitalization (median: 3 days vs. 2 days; p<0.001), underwent surgery more frequently (55.4% vs. 37.4%; p<0.001), and had higher mortality (2.9% vs. 0.7%; p=0.003). Possible covariates for mortality were examined and following logistic regression, self-inflicted injury remained associated with higher death rates compared to assault (OR 4.027, CI95% 1.380, 11.749; p=0.011). ConclusionIn this study, patients with isolated self-inflicted abdominal injuries had higher mortality and more frequently underwent abdominal surgery.
Highlights
MethodsAll patients with isolated abdominal stab wound (SW) admitted to 19 Trauma Centers in Israel between the years 1997 and 2018 were included in the study
Self-inflicted injury is a leading cause of death worldwide
Compared to Group II, Group I patients were older, had more females (28.7% vs 4.9%, p
Summary
All patients with isolated abdominal stab wound (SW) admitted to 19 Trauma Centers in Israel between the years 1997 and 2018 were included in the study. Group I included patients with self-inflicted injury and group II - victims of assault. The data was retrospectively collected from the records of the Israeli National Trauma Registry (INTR) in the National Center for Trauma and Emergency Medicine Research at The Gertner Institute for Epidemiology and Health Policy Research. The INTR records data from all trauma patients with an ICD-9CM diagnosis code between 800 and 959.9, except for suffocations, drownings and poisoning, in almost all trauma centers in Israel. The INTR records all casualties hospitalized due to injury, those who died in the ED and those were transferred to another hospital. Electronic files are transferred to the Israel National Center for Trauma and Emergency Medicine Research for quality assurance, in addition to structured logical tests in the registry software
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