Kuehl Silke, Nelson Katherine, Collings Sunny
Social Psychiatry and Population Mental Health Research Unit, University of Otago Wellington, PO Box 7343, Wellington South, Wellington 6024, New Zealand.
N Z Med J. 2012 Dec 14;125(1367):70-9.
To describe the number, characteristics and management of patients who presented to an emergency department (ED) with intentional self-harm and then re-presented for any reason within 1 week, over a 1-year period.
A retrospective records review from one New Zealand ED over 12 months.
Of the 120 patients who attended the ED more than once with intentional self-harm, 48 re-presented on 73 occasions within 7 days of the index presentation. Of the re-presentations, 55% occurred within 1 day. Mental health assessments by emergency department staff were minimal; challenging incidents occurred in 40% of presentations; and there was an increase in the inpatient admission rate for second presentations.
We identified a small group of patients who rapidly re-present to the ED following intentional self-harm. The reasons behind those re-presentations could include limited mental health assessments in ED and inadequate follow-up on discharge. System improvements in the ED including better collaboration with mental health services could improve how services address the needs of patients who present with intentional self-harm and reduce costs.
描述在1年时间内，因故意自我伤害前往急诊科（ED）就诊，随后在1周内因任何原因再次就诊的患者数量、特征及管理情况。
对新西兰一家急诊科12个月的记录进行回顾性研究。
在120名不止一次因故意自我伤害到急诊科就诊的患者中，48人在首次就诊后的7天内有73次再次就诊。在这些再次就诊中，55%发生在1天内。急诊科工作人员进行的心理健康评估极少；40%的就诊出现了具有挑战性的事件；第二次就诊的住院率有所上升。
我们识别出一小部分在故意自我伤害后迅速再次前往急诊科就诊的患者。这些再次就诊背后的原因可能包括急诊科心理健康评估有限以及出院后随访不足。急诊科的系统改进，包括与心理健康服务机构更好地协作，可能会改善服务机构满足故意自我伤害患者需求的方式并降低成本。
