Abstract
In a prospective audit of 1,096 consecutive attendances by deliberate self-poisoning patients at an accident and emergency department (A&E), such patients were discharged directly from A&E on 31% of occasions. Outcome and risk were compared for patients admitted to hospital and discharged directly from A&E. In the following year repetition of self-poisoning occurred in the same proportions of patients admitted to hospital and discharged from A&E (12%, relative risk 1.02). Suicide during the following three years occurred in 1.3% of patients admitted and 1.1% of those discharged (relative risk 1.2). Patients admitted to hospital from A&E were those likely to be at greater risk: they were older, reported more physical ill-health, expressed a threat or left a note more often, and had more frequently experienced psychiatric inpatient care. Thus, nearly one-third of deliberate self-poisoning attenders were discharged from A&E; outcomes were similar despite higher risk among admitted patients, suggesting that brief admission has some benefit.
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Contributor Information
David Owens, Senior Lecturer in Psychiatry, University of Leeds University Hospital, Nottingham.
Michael Dennis, Senior Registrar in Psychiatry University Hospital, Nottingham.
Susan Jones, Lecturer in General Practice University Hospital, Nottingham.
Andrew Dove, Consultant in Accident and Emergency University Hospital, Nottingham.
Shivraj Dave, Consultant in Accident and Emergency University Hospital, Nottingham.