{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:30:53Z","timestamp":1754152253146,"version":"3.41.2"},"reference-count":0,"publisher":"California Digital Library (CDL)","issue":"4","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Western Journal of Emergency Medicine"],"abstract":"<p>Introduction: Psychiatric conditions are common presentations to the emergency department, and their prevalence has been steadily increasing. Part of this spectrum of presentations is self-directed violence. Self-directed violence involves suicidal acts and non-suicidal self-injuries that can result in serious morbidity and mortality. This study examines characteristics and outcomes of patients who presented to US trauma centers with self-inflicted injuries and identifies factors associated with survival to hospital discharge in this patient population. Methods: We extracted data in a retrospective, observational manner from the 2020 National Trauma Data Bank (NTDB) 2020. The NTDB includes data from over 900 trauma centers (900\/2,294 total trauma centers in the United States, 39.2%). We performed a descriptive analysis of characteristics, injury patterns and outcomes. All variables were tabulated by outcome (died: yes\/no). We then conducted a multivariable logistic regression using a stepwise technique to identify factors associated with the patients\u2019 survival to hospital discharge. Results: A total of 12,824 patients with self-inflicted injuries were included in this analysis. Their median age was 35 years (interquartile range 25-50), and they were mostly males (74.7%) and White (69.6%). Patients were mostly transported by ground ambulance (78.9%) to Level I (60.6%) and Level II (33.5%) trauma centers. Most patients had a pre-existing condition (70.2%). These included mental\/personality disorder (48.2%), alcohol use disorder (11.5%), and substance use disorder (17.7%). The most common mechanism of injury was penetrating trauma (71.6%), followed by blunt trauma (18.0%) and burns (1%). Cutting\/piercing was the most common penetrating mechanism (60%) compared with firearm-related trauma (40%). Severe injury (Injury Severity Score \u2265 16) was present in 32.8% of patients. A positive alcohol screen and\/or a positive drug screen were reported in 30.2% and 31.2% of patients, respectively. Most patients were admitted to hospital (86%). Overall mortality rate at hospital discharge was 21.7%. We identified Important factors associated with survival to hospital discharge in this patient population. Conclusion: Patients with self-inflicted injuries treated at US trauma centers have high rates of injury severity and a high mortality rate. This study sheds light on the complex and resource- intensive care needed for this vulnerable patient population.<\/p>","DOI":"10.5811\/westjem.42022","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T20:33:01Z","timestamp":1752870781000},"source":"Crossref","is-referenced-by-count":0,"title":["Characteristics and Outcomes of Patients with Self-directed Violence Presenting to Trauma Centers in the United States"],"prefix":"10.5811","volume":"26","author":[{"given":"Gregory","family":"Jasani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Garrett","family":"Cavaliere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rana","family":"Bachir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Van Remmen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazen","family":"El-Sayed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2025,7,18]]},"container-title":["Western Journal of Emergency Medicine"],"original-title":[],"link":[{"URL":"https:\/\/escholarship.org\/content\/qt8c984357\/qt8c984357.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T22:19:52Z","timestamp":1753136392000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/8c984357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,18]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,7,19]]}},"URL":"https:\/\/doi.org\/10.5811\/westjem.42022","relation":{},"ISSN":["1936-9018"],"issn-type":[{"type":"electronic","value":"1936-9018"}],"subject":[],"published":{"date-parts":[[2025,7,18]]}}}