Hyun Ji Young, Son Yae Jun, Kim SuHyun, Bae Keum Seok, Chung Jae Sik, Park Il Hwan, Choi Young Un
CHA University School of Medicine, Seongnam 24341, Republic of Korea.
Department of Medical Informatics and Biostatistics, Artificial Intelligence Big Data Medical Center, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea.
Emerg Med Int. 2025 May 23;2025:6058288. doi: 10.1155/emmi/6058288. eCollection 2025.
Among patients with trauma, those with self-harm exhibit different characteristics than those who experience general accidents. Unstable vital signs following a severe injury often limit accurate imaging and injury assessment during initial treatment, rendering decision-making challenging for definitive care. Identifying correlations between damage area and severity can improve predictions and treatment decisions. We identify differences in characteristics of trauma between patients who experienced general accidents and those who attempted suicide. This study investigates differences in trauma characteristics between accidental and self-harm injuries in a single-center cohort of 10,180 patients (2015-2023). We analyzed age, sex, trauma mechanism, intention of suicide, Abbreviated Injury Scale (AIS) score, injury severity score (ISS), and height for falls. We divided intentionality into accident and self-harm and analyzed and compared their characteristics. The self-harm group was significantly younger (mean: 10 years younger, < 0.05) and had a higher proportion of falls (41.0%) and stab injuries (48.9%). Self-harm falls were more severe, with a mean fall height of 10.8m (vs. 4.14m in the accidental group, < 0.001), resulting in a higher ISS (18.6 vs. 15.5, < 0.05). In the self-harm group, fall attempts were common among teenagers and those in their 20s, while knife injuries were common in individuals in their 40s and 50s. This study confirmed the relationship between the injury mechanism and AIS in patients with trauma. The damaged area and degree of damage differed between the self-harm and accident groups, even with the same mechanism. Understanding these patterns can enhance initial ER assessments and reduce missed injuries in high-risk patients.
在创伤患者中,自残患者与经历一般事故的患者表现出不同的特征。重伤后不稳定的生命体征常常限制了初始治疗期间准确的影像学检查和损伤评估,给确定性治疗的决策带来挑战。识别损伤区域与严重程度之间的相关性可以改善预测和治疗决策。我们确定了经历一般事故的患者与自杀未遂患者在创伤特征上的差异。本研究调查了一个包含10180例患者(2015 - 2023年)的单中心队列中意外损伤与自残损伤在创伤特征上的差异。我们分析了年龄、性别、创伤机制、自杀意图、简明损伤定级(AIS)评分、损伤严重程度评分(ISS)以及跌倒时的身高。我们将故意性分为意外和自残,并分析和比较了它们的特征。自残组患者明显更年轻(平均年轻10岁,P < 0.05),跌倒(41.0%)和刺伤(48.9%)的比例更高。自残性跌倒更严重,平均跌倒高度为10.8米(意外组为4.14米,P < 0.001),导致ISS更高(18.6对15.5,P < 0.05)。在自残组中,青少年和20多岁的人常见跌倒企图,而40多岁和50多岁的人常见刀伤。本研究证实了创伤患者损伤机制与AIS之间的关系。即使机制相同,自残组和意外组的损伤区域和损伤程度也有所不同。了解这些模式可以加强急诊室的初始评估,并减少高危患者的漏诊。