Self-harm characteristics of younger-old and older-old adults admitted to emergency departments: a nationwide study

Abstract

Self-harm is a major risk factor for suicide or self-harm repetition. As the global population ages, it is important that older adults are not considered a homogeneous population group. In this study, we aimed to identify the characteristics of elderly self-harm and compare these between age groups who were admitted to emergency departments in South Korea. A retrospective study was conducted using the Emergency Department-based Injury In-depth Surveillance (EDIIS) database in South Korea. We included self-harm patients aged 65 years or more. Inclusions were divided into two groups by age: younger-old (65 to 79 years) and older-old (≥80 years). The primary outcome was the difference between two age groups; a secondary analysis was conducted to identify potential risk factors for in-hospital mortality among patients with self-harm. Among a total of 2,116,039 patients recorded in database, there was a total of 5986 self-harm patients. Self-harm incidence increased with age through the mid-70s, peaking at age 75 (3.59%, 95% confidence interval, 3.27%–3.91%). Two age groups showed significant differences in demographic variables, such as sex, alcohol consumption, injury location, and motivation. Risk factors for self-harm in older adults included older age, male sex, no alcohol consumption, emergency medical service use, and the method of self-harm. The incidence of self-harm among older adults peaked in the mid-70s and decreased thereafter. A higher mortality rate was observed among older-old adults, compared to younger-old adults, and this may be attributed to resilient physical status naturally derived from older age.