Emergency department discharges for self-inflicted cutting injuries

Purpose: While self-inflicted cutting is not a new phenomenon, it has recently received more attention. Prior research shows a strong correlation between cutting, mental illness, and substance abuse. This population-based study described the epidemiology of self-inflicted cutting injuries in the emergency department (ED) discharge database.

Methods: Data for all patients treated and discharged from 16 EDs in a metropolitan county are voluntarily reported and maintained in the ED database. Included in this analysis were all discharges for self-inflicted injury (E950-E959) during FY2005/2006. Cutting self-inflicted injuries were identified using E956. Rates are reported as discharges per 100,000 population.

Results: Over the one-year study period, there were 2,028 ED discharges for self-inflicted injury, representing 0.35% of all discharges. The annual rate was 66 per 100,000. 32% of all self-inflicted injury discharges were for cutting (21 per 100,000). Among those with cutting injuries, the mean age was 30 years, and most common among females ages 15-19 (81 per 100,000). Discharges ages 25-34 were more often male (31 per 100,000) than female (23 per 100,000). Whites had higher rates than Blacks or Hispanics (26, 21 and 15 per 100,000). 66% of injuries were to the elbow/forearm, and 76% produced an open versus superficial wound. 66% were diagnosed with a mental illness and 30% with alcohol use/abuse. 59% were sent home for self-care and 22% to a psychiatric hospital.

Conclusions: ED discharges for self-inflicted cutting injuries are common and serious. The high prevalence of co-occurring mental illness and alcohol use/abuse support multidisciplinary intervention efforts.