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FACTORS INFLUENCING DISPOSITION TO INPATIENT PSYCHIATRIC TREATMENT IN A NATIONAL SAMPLE OF PATIENTS TREATED FOR SELF-INFLICTED INJURIES
Libby Schroeder, *Andrew Schramm, *Carisa Bergner, *Sara Kohlbeck, *David Milia, *Terri deRoon-Cassini
Medical College of Wisconsin, Whitefish Bay, WI

OBJECTIVE(S): Suicide is a leading cause of death in the U.S., and trauma centers play a key role in providing treatment to those with self-inflicted injuries. Little is known about the disposition of these patients in comparison to those with other injury types. We describe differences in treatment, length of stay, and discharge disposition among patients treated for self-inflicted injuries.
METHODS:
National Trauma Database was queried for patients treated for self-inflicted injuries from 2010-2018 using assault patients as a comparison.
RESULTS:
Sample included 77,731 patients with self-inflicted injuries and 568,134 patients who were assaulted. Patients with self-inflicted injuries were more likely to require operative intervention (30.6% vs 21.7%, p<.000) and had a longer length of stay (8.36 13.4) than patients who were assaulted (5.0 8.8, p<.000). Forty-five percent of the self-inflicted group discharged home, 29% to inpatient rehab and 22% to inpatient psychiatric facility. Uninsured self-inflicted patients were less likely to get inpatient psychiatric treatment (17.9%) than those with insurance (23.1%, p<.001) and racial minority patients were less likely to get inpatient psychiatric treatment (18.9%) than non-minority patients (23.8%, p<.001). Among patients with self-inflicted injury, those who discharged to inpatient psychiatric treatment had significantly lower ISS (7.24 7.5) than those who did not (8.69 9.1, p<.001).
CONCLUSIONS:
Most patients treated at a trauma center for self-inflicted injury do not discharge to inpatient psychiatric treatment. While injury severity has previously been shown to predict future suicide, it was not associated with greater odds of inpatient psychiatric treatment in this sample. Racial minority patients, and those without insurance, face disparities in access to inpatient psychiatric treatment following self-inflicted injury.


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