Marriott Richard, Horrocks Judith, House Allan, Owens David
Leeds Mental Health Trust, Leeds, UK.
Int J Geriatr Psychiatry. 2003 Jul;18(7):645-52. doi: 10.1002/gps.892.
Older people who undertake self-harm are at higher suicide risk than are younger patients. This study examines whether this greater risk is reflected in the assessment and after-care that older patients receive when they attend accident and emergency.
This cross-sectional study, set in the two accident and emergency departments in a large industrial city in Northern England, compared 141 consecutive attendances due to self-harm among older patients (aged 55 years and over) with a random sample of 125 attendances of younger people (aged 15-54) attending because of self-harm. Data were drawn from accident and emergency records and from psychiatric and general hospital casenotes.
Compared with the younger group, older patients were significantly more likely to be admitted from accident and emergency to the general hospital, to receive a specialist assessment whilst at the hospital, and to be offered psychiatric after-care-either as a psychiatric in-patient or an out-patient.
Fortunately, older people attending accident and emergency following self-harm seemed likely to receive psychosocial assessment from a mental health specialist, and they were much more likely than younger patients to be offered after-care. Hospitals will need to monitor accident and emergency and other records if they are to check that their services are responding to the high risks seen in older patients.
进行自我伤害的老年人比年轻患者有更高的自杀风险。本研究调查在老年人因自我伤害到急诊就诊时，这种更高的风险是否在评估及后续护理中有所体现。
这项横断面研究在英格兰北部一个大型工业城市的两个急诊科开展，将141例连续就诊的老年自我伤害患者（年龄55岁及以上）与125例因自我伤害就诊的年轻患者（年龄15 - 54岁）的随机样本进行比较。数据取自急诊记录以及精神科和综合医院病历。
与年轻组相比，老年患者从急诊转入综合医院、在医院接受专科评估以及获得精神科后续护理（无论是作为精神科住院患者还是门诊患者）的可能性显著更高。
幸运的是，因自我伤害到急诊就诊的老年人似乎有可能接受心理健康专家的社会心理评估，并且他们比年轻患者更有可能获得后续护理。如果医院要检查其服务是否针对老年患者中存在的高风险做出反应，就需要监测急诊及其他记录。
