Re-presentation and suicide rates in emergency department patients who self-harm

Objective: To investigate adult presentations to North Shore Hospital, Auckland, New Zealand, following deliberate self-harm, determine re-presentation and suicide rates and investigate the characteristics of those patients who re-present. Methods: Retrospective review of a cohort of adult patients presenting to North Shore Hospital Emergency Care Centre in Auckland, New Zealand, with deliberate self-harm between 1 January 2001 and 31 August 2002, using data from the National Minimum Data Set and Hospital Discharge Database. The re-presentation rate was calculated as the percentage of patients presenting a second time within 1 year of their index presentation. The suicide rate was calculated as the percentage of patients with a coroner's verdict of suicide within 1 year of their index presentation of deliberate self-harm. Results: There were 1055 presentations by 754 people during the presentation period. Of these 754 people, 136 presented for a second time within a year of the index case (136/754 [18.0%, 95% CI 15.5-21.0]). Eight of the seven hundred and fifty-four people went on to commit suicide within 1 year (8/754 [1.1%, 95% CI 0.5-2.1]). Self-poisoning was the most common method of self-harm. Minor tranquillizers were used more commonly in the group who re-presented. Conclusion: Re-presentation and suicide rates in our study were similar to previously published rates. Further research is needed to identify strategies to reduce re-presentations and excess mortality in all people who deliberately self-harm.