[Suicide in old age: the underestimated risk. An analysis of 1,894 patients in the Trauma Registry of the German Trauma Society].

BACKGROUND: In Germany, the number of suicides and suicide attempts (n = 9,616) exceeds the number of traffic deaths (n = 4,152) by far. It is unknown how many suicide attempts are treated in trauma centres. Due to a lack of registered suicide attempts in Germany, no data exist about injury patterns, mortality or duration of treatment.
MATERIALS AND METHODS: We prospectively analysed data collected on emergency room patients from the Trauma Registry of the German Trauma Society (TR-DGU) between 1993 and 2009. All patients with an Injury Severity Score (ISS) ≥ 9, age ≥ 18 years and a documented suicide attempt were included in the study. The main target points were epidemiological data, cause of injury and injury patterns, ISS, gender distribution, mortality, duration of treatment and patients' psychiatric medical history.
RESULTS: Of 42,248 patients of the TR-DGU, 1,894 were included in the study; 274 patients were ≥ 65 years old. The most common method was jumping from a height among the group of female patients, whereas the use of firearms predominated in the male group. The average ISS was 31 points in all patient groups. The mortality was highest in patients aged ≥ 65 years. Psychiatric disorders were found predominantly in women.
CONCLUSION: Of all severely injured patients in trauma centres, 5% suffered their injuries as a consequence of a suicidal attempt. In women who survived initially, jumping from a height was the most frequently chosen method. In elderly men the use of firearms dominated. The significant increase of mortality in elderly patients, preexisting depressive conditions and the expected increase in the number of these patients as a consequence of the changed age pyramid should lead to more intensive recognition and treatment of this disease and possibly improved suicide prevention.