TY - JOUR
PY - 2018//
TI - Self-inflicted gunshot wounds: readmission patterns
JO - Journal of surgical research
A1 - Rajasingh, Charlotte M.
A1 - Tennakoon, Lakshika
A1 - Staudenmayer, Kristan L.
SP - 22
EP - 28
VL - 223
IS -
N2 - BACKGROUND: Self-inflicted gunshot wounds (SI-GSWs) are often fatal, but roughly 20% of individuals survive. What happens to survivors after the initial hospitalization is unknown. We hypothesized that the SI-GSW survivors are frequently readmitted and that the pattern of readmission is different from that of the survivors of non-GSW self-harm (SH).
METHODS: We conducted a retrospective cohort analysis using the 2013 and 2014 Nationwide Readmission Database. Patients with any diagnosis indicating deliberate SH in the first 6 months of the year were included. This group was divided into those who had SI-GSW as their mechanism and those who did not. Weighted numbers are reported.
RESULTS: A total of 1987 patients were admitted for SI-GSW in the study period. Many (n = 506, 26%) experienced at least one readmission in 6 months. When compared with non-GSW SH patients, readmission rates were not statistically different (26% versus 26%, P = 0.60). However, readmissions for repeat SH were lower for the SI-GSW cohort (3% versus 7%, P = 0.004). Readmission for the SI-GSW cohort less frequently had a primary diagnosis of psychiatric illness (28% versus 57%, P < 0.001). In multivariate analysis, there was no difference in odds ratios (OR) of all-cause readmission between the two groups. SI-GSW was associated with a lower OR of repeat SH readmission compared with non-GSW SH (OR 0.65, P = 0.039).
CONCLUSIONS: Readmissions after an SI-GSW are frequent, highlighting the burden of this injury beyond the index hospitalization. There are differences in readmission patterns for SI-GSW patients versus non-GSW SH patients, and this suggests that prevention and follow-up strategies may differ between the two groups.
Copyright © 2017 Elsevier Inc. All rights reserved.
Language: en
LA - en SN - 0022-4804 UR - http://dx.doi.org/10.1016/j.jss.2017.10.009 ID - ref1 ER -