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Erschienen in: European Journal of Trauma and Emergency Surgery 1/2012

01.02.2012 | Original Article

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

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

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 1/2012

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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.
Literatur
1.
Zurück zum Zitat 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 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
2.
Zurück zum Zitat 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 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
3.
Zurück zum Zitat 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 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
4.
Zurück zum Zitat Statistisches Bundesamt Deutschland (2007). Statistisches Bundesamt Deutschland (2007).
5.
Zurück zum Zitat 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 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
6.
Zurück zum Zitat 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 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
7.
Zurück zum Zitat 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 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
8.
Zurück zum Zitat 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 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
9.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Isbister ES, Roberts JA. Autokabalesis: a study of intentional vertical deceleration injuries. Injury. 1992;23:119–22.PubMedCrossRef Isbister ES, Roberts JA. Autokabalesis: a study of intentional vertical deceleration injuries. Injury. 1992;23:119–22.PubMedCrossRef
16.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Warner KG, Demling RH. The pathophysiology of free-fall injury. Ann Emerg Med. 1986;15:1088–93.PubMedCrossRef Warner KG, Demling RH. The pathophysiology of free-fall injury. Ann Emerg Med. 1986;15:1088–93.PubMedCrossRef
22.
Zurück zum Zitat Schmelz A, Ziegler D, Beck A, Kinzl L, Gebhard F. Costs for acute, stationary treatment of polytrauma patients. Unfallchirurg. 2002;105:1043–8.PubMedCrossRef 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.
Zurück zum Zitat 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 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
Metadaten
Titel
Multiple blunt trauma after suicidal attempt: an analysis of 4,754 multiple severely injured patients
verfasst von
T. Topp
T. Müller
I. Kiriazidis
R. Lefering
S. Ruchholtz
C. A. Kühne
Trauma Registry of the German Trauma Society
Publikationsdatum
01.02.2012
Verlag
Springer-Verlag
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 1/2012
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-011-0114-5

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