Causes of death in the decade after hospitalisation for injury during adolescence: a study using linked hospital admissions and death registrations data
ABSTRACT Objectives To quantify risks of cause-specific death up to ten years after discharge from an emergency admission to hospital for violent, self-inflicted, or drug/alcohol-related injury, during adolescence. To compare these risks by type of original injury, and with risks after accident-r...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Swansea University
2017-04-01
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| Series: | International Journal of Population Data Science |
| Online Access: | https://ijpds.org/article/view/275 |
| _version_ | 1797426439562199040 |
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| author | Annie Herbert Ruth Gilbert David J Cottrell Arturo Gonzalez-Izquierdo Leah Li |
| author_facet | Annie Herbert Ruth Gilbert David J Cottrell Arturo Gonzalez-Izquierdo Leah Li |
| author_sort | Annie Herbert |
| collection | DOAJ |
| description | ABSTRACT
Objectives
To quantify risks of cause-specific death up to ten years after discharge from an emergency admission to hospital for violent, self-inflicted, or drug/alcohol-related injury, during adolescence. To compare these risks by type of original injury, and with risks after accident-related injury.
Approach
We used admissions data for England linked to death registrations from 1997 to 2012. We identified emergency admissions for injury in 10-19y olds and categorised type of injury as either violent, self-inflicted, drug/alcohol-related, or accident-related (no record of violent, self-inflicted, or drug/alcohol-related injury, but record of an accident), using ICD-10 codes in admission records. We categorised causes of death as homicide, suicide, drug/alcohol-related, accidental (excluding drug/alcohol-related accidents), or ‘other’ (remaining causes), using ICD-9 and ICD-10 codes from death registration records. We estimated cumulative risks of cause-specific death in the ten years after discharge, by sex and type of original injury. We used time-to-event regression models to estimate risks of cause-specific death, after violent, self-inflicted or drug/alcohol-related injury (relative to those after accident-related injury), adjusted for age-group (10-15, 16-17, 18-19y) and chronic condition status (yes/no; indicated by ICD-10 codes in past year admission records), and stratified by sex.
Results
There were 333,009 adolescents admitted for violent, self-inflicted, or drug/alcohol-related injury (girls 181,926, boys 181,053), and 649,818 for accident-related injury (girls 166,462, boys 483,356). There were 4,782 deaths in the ten years after discharge: 2,415 after violent, self-inflicted or drug/alcohol-related injury (girls 873, boys 1,542) and 2,367 after accident-related injury (girls 439, boys 1,928). Deaths after violent, self-inflicted or drug/alcohol-related injury injury were mostly accounted for by suicide (girls 35.8% of all deaths, boys 34.2%) or drug/alcohol-related death (girls 31.7%, boys 35.6%). Risks of suicide were similar to those for drug/alcohol-related death, regardless of the type of original injury. Adjusted risks of death were 1.4 to 6.8 times greater than after accident-related injury (by cause and sex).
Conclusion
Adolescent girls and boys discharged after violent, self-inflicted, or drug/alcohol-related injury had similar risks of suicide and drug/alcohol related death, regardless of the category of the original injury. These adolescents also had increased risks of cause-specific deaths compared to those discharged after accident-related injury. Current practice to assess and reduce risks of future harm after self-inflicted injury should be extended to adolescents discharged after violent or drug/alcohol-related injury. Preventive strategies should address risks of drug/alcohol-related death as well as risks of suicide. |
| first_indexed | 2024-03-09T08:30:13Z |
| format | Article |
| id | doaj.art-e6e3fd0bf7fe4dd89e002ce157744e2f |
| institution | Directory Open Access Journal |
| issn | 2399-4908 |
| language | English |
| last_indexed | 2024-03-09T08:30:13Z |
| publishDate | 2017-04-01 |
| publisher | Swansea University |
| record_format | Article |
| series | International Journal of Population Data Science |
| spelling | doaj.art-e6e3fd0bf7fe4dd89e002ce157744e2f2023-12-02T20:22:55ZengSwansea UniversityInternational Journal of Population Data Science2399-49082017-04-011110.23889/ijpds.v1i1.275275Causes of death in the decade after hospitalisation for injury during adolescence: a study using linked hospital admissions and death registrations dataAnnie Herbert0Ruth Gilbert1David J Cottrell2Arturo Gonzalez-Izquierdo3Leah Li4Department of Epidemiology and Public Health, University College LondonInstitute of Child Health, University College LondonInstitute of Health Sciences, University of LeedsFarr Institute of Health Informatics, University College LondonInstitute of Child Health, University College LondonABSTRACT Objectives To quantify risks of cause-specific death up to ten years after discharge from an emergency admission to hospital for violent, self-inflicted, or drug/alcohol-related injury, during adolescence. To compare these risks by type of original injury, and with risks after accident-related injury. Approach We used admissions data for England linked to death registrations from 1997 to 2012. We identified emergency admissions for injury in 10-19y olds and categorised type of injury as either violent, self-inflicted, drug/alcohol-related, or accident-related (no record of violent, self-inflicted, or drug/alcohol-related injury, but record of an accident), using ICD-10 codes in admission records. We categorised causes of death as homicide, suicide, drug/alcohol-related, accidental (excluding drug/alcohol-related accidents), or ‘other’ (remaining causes), using ICD-9 and ICD-10 codes from death registration records. We estimated cumulative risks of cause-specific death in the ten years after discharge, by sex and type of original injury. We used time-to-event regression models to estimate risks of cause-specific death, after violent, self-inflicted or drug/alcohol-related injury (relative to those after accident-related injury), adjusted for age-group (10-15, 16-17, 18-19y) and chronic condition status (yes/no; indicated by ICD-10 codes in past year admission records), and stratified by sex. Results There were 333,009 adolescents admitted for violent, self-inflicted, or drug/alcohol-related injury (girls 181,926, boys 181,053), and 649,818 for accident-related injury (girls 166,462, boys 483,356). There were 4,782 deaths in the ten years after discharge: 2,415 after violent, self-inflicted or drug/alcohol-related injury (girls 873, boys 1,542) and 2,367 after accident-related injury (girls 439, boys 1,928). Deaths after violent, self-inflicted or drug/alcohol-related injury injury were mostly accounted for by suicide (girls 35.8% of all deaths, boys 34.2%) or drug/alcohol-related death (girls 31.7%, boys 35.6%). Risks of suicide were similar to those for drug/alcohol-related death, regardless of the type of original injury. Adjusted risks of death were 1.4 to 6.8 times greater than after accident-related injury (by cause and sex). Conclusion Adolescent girls and boys discharged after violent, self-inflicted, or drug/alcohol-related injury had similar risks of suicide and drug/alcohol related death, regardless of the category of the original injury. These adolescents also had increased risks of cause-specific deaths compared to those discharged after accident-related injury. Current practice to assess and reduce risks of future harm after self-inflicted injury should be extended to adolescents discharged after violent or drug/alcohol-related injury. Preventive strategies should address risks of drug/alcohol-related death as well as risks of suicide.https://ijpds.org/article/view/275 |
| spellingShingle | Annie Herbert Ruth Gilbert David J Cottrell Arturo Gonzalez-Izquierdo Leah Li Causes of death in the decade after hospitalisation for injury during adolescence: a study using linked hospital admissions and death registrations data International Journal of Population Data Science |
| title | Causes of death in the decade after hospitalisation for injury during adolescence: a study using linked hospital admissions and death registrations data |
| title_full | Causes of death in the decade after hospitalisation for injury during adolescence: a study using linked hospital admissions and death registrations data |
| title_fullStr | Causes of death in the decade after hospitalisation for injury during adolescence: a study using linked hospital admissions and death registrations data |
| title_full_unstemmed | Causes of death in the decade after hospitalisation for injury during adolescence: a study using linked hospital admissions and death registrations data |
| title_short | Causes of death in the decade after hospitalisation for injury during adolescence: a study using linked hospital admissions and death registrations data |
| title_sort | causes of death in the decade after hospitalisation for injury during adolescence a study using linked hospital admissions and death registrations data |
| url | https://ijpds.org/article/view/275 |
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