Gunnell D J, Brooks J, Peters T J
Department of Social Medicine, Canynge Hall, Bristol.
J Epidemiol Community Health. 1996 Feb;50(1):24-9. doi: 10.1136/jech.50.1.24.
To describe the epidemiology, management, and outcome of parasuicide in the south west of England.
Descriptive analysis using routine information systems.
The former South Western Regional Health Authority, population aged 10 and over: 2.9 million.
These comprised 5080 residents of the South Western Health Region, admitted on 5770 occasions for parasuicide between April 1992 and March 1993 to hospitals in the south west.
Person based age and sex standardised admission ratios for parasuicide; readmission for parasuicide in the subsequent 12 months; admission to psychiatric hospital after parasuicide; in-hospital mortality for those admitted after attempted suicide.
The overall rate of parasuicide admission was 174 per 100,000 per year. Rates were highest in males aged 20-24 (381 per 100,000) and in females aged 15-19 (625 per 100,000). Parasuicide is the third most frequent cause of acute medical admission in the south west. A total of 10.0% of admissions received psychiatric inpatient care as a direct result of their parasuicide admission and 10.1% were readmitted in the following 12 months with a repeat episode of parasuicide. Significant variations in standardised admission ratios for parasuicide were observed between the districts. Some of this variation is related to socioeconomic differences between districts, the rest is probably due to differences in practice between districts. There is no clear evidence that these variations result in differences in readmission rates. Districts where psychiatric inpatient facilities were located on the same site as the general hospital tended to admit a greater percentage of parasuicide patients for psychiatric inpatient care. A quarter of all suicide deaths from overdose occurred in hospital. It is estimated that there are 87,000 parasuicide admissions in England and Wales annually.
Parasuicide is a common cause of acute hospital admission and there is evidence that hospital admission practices for parasuicide vary across the south west. Randomised controlled trials are needed to evaluate the most appropriate form of management for those patients who do not require admission on medical grounds.
描述英格兰西南部蓄意自伤的流行病学特征、管理情况及结局。
利用常规信息系统进行描述性分析。
原西南地区卫生局，10岁及以上人口：290万。
包括5080名西南健康地区居民，在1992年4月至1993年3月期间因蓄意自伤5770次入住西南部医院。
基于人群的蓄意自伤年龄和性别标准化入院率；随后12个月内蓄意自伤再入院情况；蓄意自伤后入住精神病院情况；自杀未遂后入院患者的院内死亡率。
蓄意自伤的总体入院率为每年每10万人中有174例。20 - 24岁男性（每10万人中有381例）和15 - 19岁女性（每10万人中有625例）的发生率最高。蓄意自伤是西南部急性入院的第三大常见原因。共有10.0%的入院患者因蓄意自伤入院而直接接受了精神科住院治疗，10.1%在接下来的12个月内因再次蓄意自伤而再次入院。各地区之间蓄意自伤标准化入院率存在显著差异。部分差异与地区间的社会经济差异有关，其余可能是由于地区间的医疗实践差异。没有明确证据表明这些差异会导致再入院率的差异。精神病院住院设施与综合医院位于同一地点的地区，往往有更高比例的蓄意自伤患者接受精神科住院治疗。所有因服药过量导致的自杀死亡中有四分之一发生在医院。据估计，英格兰和威尔士每年有87000例蓄意自伤入院病例。
蓄意自伤是急性住院的常见原因，有证据表明西南部各地区对蓄意自伤的住院治疗方式存在差异。需要进行随机对照试验，以评估那些因医疗原因无需住院的患者最适宜的管理形式。
