Sex-related differences in childhood and adolescent self-inflicted injuries: a National Trauma Databank review

Abstract

Background: Recent reports have demonstrated increasing lethality among young women after inflicted injuries (SII). The aim of this study was to examine sex differences in the methods and outcomes of childhood and adolescent SII.

Methods: The National Trauma Databank (v 7.0) was used to identify all patients 18 years or younger who sustained a SII. Demographic data, clinical data, and outcomes were compared between male and female patients.

Results: During the study period, a total of 1853 (61.1%) male and 1182 (38.9%) female patients sustained a SII. The most common SII mechanism in male patients was gunshot wound (32.1% vs 6.8%, P < .001); in female patients, poisoning (45.6% vs 9.6%, P < .001). For younger patients (<12 years) hanging was the most common method for both male and female patients (36.5% and 29.2%, respectively). The most lethal method in both male and female patients was gunshot wound (32.3% and 38.0%, respectively). This was followed by hanging which had a high rate of lethality particularly in male adolescents 14 years or younger (36.5% and 33.2% for males <12 years and 12-14 years, respectively).

Conclusion: Self-inflicted injuries in childhood and adolescence show distinct sex differences primarily with regard to mechanism. Males favor shooting; females, poisoning; younger ages, hanging. Gunshot wound and hanging were the 2 most lethal methods of self-inflicted injury.