Skip to main content

Multiple blunt trauma after suicidal attempt: an analysis of 4,754 multiple severely injured patients

European Journal of Trauma and Emergency Surgery volume 38, pages 19–24 (2012)Cite this article

Abstract

Purpose

The suicidal attempt is a significant cause for multiple severe injuries in Germany. The aim of the present study was to obtain information regarding injury patterns, clinical treatment, and outcome.

Methods

We analyzed the data of 4,754 patients of the Trauma Registry of the German Trauma Society (1993–2007) with an Injury Severity Score (ISS) ≥9 after a suicidal jump from a height (SUICIDE) and after an accidental fall from a height (ACCIDENT).

Results

Comparing the data of 3,682 patients with accidental fall versus those with intentional fall/jump (n = 1,072), we found that male patients were predominant in the ACCIDENT group (84.9 vs. 52.2%). The SUICIDE group had more severe injuries (ISS: 31.8 vs. 26.4). The ACCIDENT group suffered more severe head injuries (51.1 vs. 36.6%). Mortality (21.4 vs. 14.2%), length of stay in hospital (29.5 vs. 26.5 days), and costs (€34,833 vs. €24,701) were higher in the SUICIDE group.

Conclusions

Falls from a height are a common cause of injury among severely injured patients. The resulting trauma composes a particular form of blunt trauma with severe and multiple injuries, which depends on the fact of whether the free fall from a height was caused by an accident or as a result of a suicidal attempt. Taking the injury severity into consideration, there is no difference in the prognosis of the patients.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. Kühne CA, Ruchholtz S, Buschmann C, Sturm J, Lackner CK, Wentzensen A, Bouillon B, Waydhas C, Weber C; AG Polytrauma DGU. Trauma centers in Germany. Status report. Unfallchirurg. 2006;109:357–66.

    PubMed  Article  Google Scholar 

  2. Liener UC, Rapp U, Lampl L, Helm M, Richter G, Gaus M, Wildner M, Kinzl L, Gebhard F. Incidence of severe injuries. Results of a population-based analysis. Unfallchirurg. 2004;107:483–90.

    PubMed  Article  CAS  Google Scholar 

  3. Juhra C, Franz D, Roeder N, Vordemvenne T, Raschke MJ. Classification of severely injured patients in the G-DRG System 2008. Unfallchirurg. 2009;112:525–32.

    PubMed  Article  CAS  Google Scholar 

  4. Statistisches Bundesamt Deutschland (2007).

  5. Schmidtke A, Bille-Brahe U, DeLeo D, Kerkhof A, Bjerke T, Crepet P, Haring C, Hawton K, Lönnqvist J, Michel K, Pommereau X, Querejeta I, Phillipe I, Salander-Renberg E, Temesváry B, Wasserman D, Fricke S, Weinacker B, Sampaio-Faria JG. Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989–1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand. 1996;93:327–38.

    PubMed  Article  CAS  Google Scholar 

  6. Hadjizacharia P, Brown CV, Teixeira PG, Chan LS, Yang K, Salim A, Inaba K, Rhee P, Demetriades D. Traumatic suicide attempts at a level I trauma center. J Emerg Med. 2010;39:411–8

    PubMed  Article  Google Scholar 

  7. Richter D, Hahn MP, Ostermann PA, Ekkernkamp A, Muhr G. Vertical deceleration injuries: a comparative study of the injury patterns of 101 patients after accidental and intentional high falls. Injury. 1996;27:655–9.

    PubMed  Article  CAS  Google Scholar 

  8. Teh J, Firth M, Sharma A, Wilson A, Reznek R, Chan O. Jumpers and fallers: a comparison of the distribution of skeletal injury. Clin Radiol. 2003;58:482–6.

    PubMed  Article  CAS  Google Scholar 

  9. Ruchholtz S. The Trauma Registry of the German Society of Trauma Surgery as a basis for interclinical quality management. A multicenter study of the German Society of Trauma Surgery. Unfallchirurg. 2000;103:30–7.

    PubMed  Article  CAS  Google Scholar 

  10. Lefering R. Development and validation of the Revised Injury Severity Classification score for severely injured patients. Eur J Trauma Emerg Surg. 2009;35:437–47.

    Article  Google Scholar 

  11. Pape HC, Grotz M, Schwermann T, Ruchholtz S, Lefering R, Rieger M, Tröger M, Graf von der Schulenburg JM, Krettek C; AG Polytrauma der DGU. The development of a model to calculate the cost of care for the severely injured—an initiative of the Trauma Register of the DGU. Unfallchirurg. 2003;106:348–57.

    PubMed  Article  Google Scholar 

  12. Böstman OM. Suicidal attempts by jumping from heights. A three-year prospective study of patients admitted to an urban university accident department. Scand J Soc Med. 1987;15:119–203.

    PubMed  Google Scholar 

  13. Etzersdorfer E, Voracek M, Kapusta N, Sonneck G. Epidemiology of suicide in Austria 1990–2000: general decrease, but increased suicide risk for old men. Wien Klin Wochenschr. 2005;117:31–5.

    PubMed  Article  Google Scholar 

  14. Dzupa V, Chmelová J, Pavelka T, Obruba P, Wendsche P, Simko P. Multicentric study of patients with pelvic injury: basic analysis of the study group. Acta Chir Orthop Traumatol Cech. 2009;76:404–9.

    PubMed  CAS  Google Scholar 

  15. Isbister ES, Roberts JA. Autokabalesis: a study of intentional vertical deceleration injuries. Injury. 1992;23:119–22.

    PubMed  Article  CAS  Google Scholar 

  16. Mathis RD, Levine SH, Phifer S. An analysis of accidental free falls from a height: the ‘spring break’ syndrome. J Trauma. 1993;34:123–6.

    PubMed  Article  CAS  Google Scholar 

  17. Aufmkolk M, Majetschak M, Voggenreiter G, Obertacke U, Schmit-Neuerburg KP. Follow-up and prognosis of severe accidental trauma in the aged. Unfallchirurg. 1997;100:477–82.

    PubMed  Article  CAS  Google Scholar 

  18. Katz K, Gonen N, Goldberg I, Mizrahi J, Radwan M, Yosipovitch Z. Injuries in attempted suicide by jumping from a height. Injury. 1988;19:371–4.

    PubMed  Article  CAS  Google Scholar 

  19. Ruchholtz S, Nast-Kolb D, Waydhas C, Schweiberer L. The injury pattern in polytrauma. Value of information regarding accident process in clinical acute management. Unfallchirurg. 1996;99:633–41.

    PubMed  Article  CAS  Google Scholar 

  20. Ruchholtz S, Pajonk FG, Waydhas C, Lewan U, Nast-Kolb D, Schweiberer L. Long-term results and quality of life after parasuicidal multiple blunt trauma. Crit Care Med. 1999;27:522–30.

    PubMed  Article  CAS  Google Scholar 

  21. Warner KG, Demling RH. The pathophysiology of free-fall injury. Ann Emerg Med. 1986;15:1088–93.

    PubMed  Article  CAS  Google Scholar 

  22. Schmelz A, Ziegler D, Beck A, Kinzl L, Gebhard F. Costs for acute, stationary treatment of polytrauma patients. Unfallchirurg. 2002;105:1043–8.

    PubMed  Article  CAS  Google Scholar 

  23. Schwermann T, Grotz M, Blanke M, Ruchholtz S, Lefering R, V d Schulenburg JM, Krettek C, Pape HC. Evaluation of costs incurred for patients with multiple trauma particularly from the perspective of the hospital. Unfallchirurg. 2004;107:563–74.

    PubMed  Article  CAS  Google Scholar 

Download references

Conflict of interest

All authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Gießen and Marburg, Baldingerstraße 1, 35033, Marburg, Germany

    T. Topp, T. Müller, I. Kiriazidis, S. Ruchholtz & C. A. Kühne

  2. Faculty of Medicine, Institute for Research in Operative Medicine, University Witten/Herdecke, Cologne, Germany

    R. Lefering

Authors
  1. T. Topp
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I. Kiriazidis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Lefering
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Ruchholtz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C. A. Kühne
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

Trauma Registry of the German Trauma Society

Corresponding author

Correspondence to T. Topp.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Topp, T., Müller, T., Kiriazidis, I. et al. Multiple blunt trauma after suicidal attempt: an analysis of 4,754 multiple severely injured patients. Eur J Trauma Emerg Surg 38, 19–24 (2012). https://doi.org/10.1007/s00068-011-0114-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-011-0114-5

Keywords

  • Suicide
  • Multiple blunt trauma
  • Mortality
  • Injury pattern
  • Epidemiology
  • Outcome