Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112461

Amy E. Donaldson, MS, Intermountain Injury Control Research Center, University of Utah School of Medicine, PO Box 581289, Salt Lake City, UT 84158-1289, 8015855962, amy.donaldson@hsc.utah.edu, Gitte Y. Larsen, MD, MPH, Pediatric Intensive Care Unit, Primary Children's Medical Center, 100 N Medical Drive, Salt Lake City, UT 84113, Lynne Fullerton Gleason, PhD, Department of Emergency Medicine, University of New Mexico School of Medicine, Center for Injury Prevention, Research, and Education, ACC 4 West, Albuquerque, NM 87131-5246, and Lenora M. Olson, MA, Intermountain Injury Control Research Center, University of Utah, PO Box 581289, Salt Lake City, UT 84158-1289.

Introduction. Utah has the fourth highest rate of undetermined deaths nationwide, with the majority due to poisoning. To determine how similar or different undetermined poisoning deaths are from suicide and unintentional poisoning deaths, we compared these three groups using 2002 statewide death certificate and medical examiner data. Methods. We randomly selected one-half of undetermined and unintentional poisoning deaths for data abstraction and included all suicides. Bivariate analyses assessed differences in demographics, death characteristics, drug toxicology, mental health history, and other potentially contributing factors. Classification and regression tree (CART) analysis utilized information from unintentional and suicide records to create a classification tree that was applied to undetermined deaths. Results. We analyzed 41 unintentional, 87 suicide, and 84 undetermined poisonings. Undetermined and unintentional decedents were both predominantly male and similar in the presence of opiates, physical health problems, and drug abuse. Undetermined decedents had the highest percentage of reported mental health and drug treatment. While none of the undetermined decedents left a suicide note, 11 cases reported previous attempt or intent to commit suicide. CART analysis identified suicidal behavior, drug abuse, physical health problems, depression, mental health treatment, and age as discriminating between suicide and unintentional poisoning and classified 18 (21%) of the undetermined deaths as suicides. Discussion. Our study suggests that manner of death determination relies on circumstance-dependent variables that may not be consistently captured by medical examiners. Undetermined decedents are a distinct group from either unintentional or suicide decedents. Improved classification of undetermined deaths has important implications for surveillance efforts.

Learning Objectives:

• Recognize the importance of accurate reporting of suicide data for surveillance efforts.
• Describe and compare demographics, drug toxicology, mental health history and other contributing factors for unintentional, suicide, and undetermined poisoning deaths.
• Discuss the potential role of standardized reporting of circumstantial data in suicide and undetermined death investigation.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.