Journal of Emergencies, Trauma, and Shock
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ORIGINAL ARTICLE
Year : 2012  |  Volume : 5  |  Issue : 3  |  Page : 228-232

Non-fatal suicide attempt by intentional stab wound: Clinical management, psychiatric assessment, and multidisciplinary considerations


1 Department of Psychiatry, Warren Alpert School of Medicine, Rhode Island Hospital, USA
2 Department of Surgery, Warren Alpert School of Medicine, Rhode Island Hospital, USA
3 Division of Trauma/Surgical Critical Care and Department of Surgery, Warren Alpert School of Medicine, Rhode Island Hospital, USA

Correspondence Address:
Shea C Gregg
Department of Surgery, Warren Alpert School of Medicine, Rhode Island Hospital
USA
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Source of Support: None, Conflict of Interest: All authors do not maintain financial and/or personal relationships with other people or organizations that could inappropriately influence (bias) our work


DOI: 10.4103/0974-2700.99688

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Background: Suicide by means of self-inflicted stab wounds is relatively uncommon and little is known about this population and their management. Materials and Methods: Retrospective review of adult trauma patients admitted to our Level-1 trauma center between January 2005 and October 2009 for management of non-fatal, self-inflicted stab wounds. Results: Fifty-eight patients were evaluated with self-inflicted stab wounds. Four patients died due to their injuries (mortality, 7%). Of the non-fatal stab wounds, 78% were male ranging in age from 19-82 (mean: 45 years). The most common injury sites were the abdomen (46%), neck (33%), and chest (20%). In terms of operative interventions, 56% of abdominal operations were therapeutic, whereas 100% of neck and chest operations were therapeutic. When assessing for suicidal ideation, 44 patients (81%) admitted to suicidal intentions whereas 10 patients (19%) described "accidental" circumstances. Following psychiatric evaluation, 8 of the 10 patients with "accidental injuries" were found to be suicidal. Overall, 54 patients (98%) met criteria for a formal psychiatric diagnosis with 48 patients (89%) necessitating inpatient or outpatient psychiatric assistance at discharge. Conclusions: Compared to previous reports of stab wounds among trauma patients, patients with self- inflicted stab wounds may have a higher incidence of operative interventions and significant injuries depending on the stab location. When circumstances surrounding a self-inflicted stabbing are suspicious, additional interviews by psychiatric care providers may uncover a suicidal basis to the event. Given the increased incidence of psychiatric illness in this population, it is imperative to approach the suicidal patient in a multidisciplinary fashion.


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