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This section of the report gives an overview of self-inflicted injuries among Hoosiers during January 2002 through June 2002, as based on data received from the Indiana Hospital and Health Association.

Figure 8: January to June 2002, there is a 10.0 ratio for self-inflicted injuries of White to Black Hoosiers.

(Source: Indiana State Department of Health, Injury Prevention Program)

The first two quarters of the Indiana 2002 hospital discharge dataset totaled 361,823 records. Of these, 14,902 had a principle diagnosis for injury and poisoning (ICD-9-CM codes 800-999). Then a query was done for suicide related ECODES (E950-E959), yielding 6% (913) patients with self-inflicted injuries specified as intentional. The average age was 35 (range: 12 to 91). Eighty-four percent of the attempts were made by persons of the white race, involving 60% females and 40% males. The majority (227 or 25%) of the injuries were among white females age 25-44 years (Figures 8,9).

Although detailed analysis by cost is unavailable, 48% of the patients identified Medicare, Medicaid and Managed Care Organizations as their primary source of payment (Table 2).

Table 3 shows the five most frequently reported ICD-9-CM codes (primary diagnosis) and Table 4 shows a listing of all Supplementary Classification of External Causes of Injury and Poisoning Codes (ECODES) for all categories of suicide attempts. Table 4 provides a detailed analysis of the various suicide attempt descriptors (ECODES) from the hospital discharge database. Note that the ECODES are not mutually exclusive since one patient can have multiple ECODES listed as part of their diagnosis.

Figure 9: From January 2002 to June 2002, a higher number of self-inflicted injuries among white females.

(Source: Indiana State Department of Health, Injury Prevention Program)

The overwhelming majority of hospital admissions for attempted suicide involved self-inflicted poisoning by solid or liquid substances (92%). Other methods of attempting suicide included cutting or piercing (41 or 3.2%), and use of firearms or explosives (26 or 2.1%). Suicide attempts by self-inflicted poisoning from gases such as carbon monoxide, hanging or strangulation, jumping from high places, or other unspecified means each involved less than 1% of hospital admissions for suicide attempts (Table 4).

The most frequent means of attempting suicide was by poisoning and involved the use of tranquilizers and other psychotropic agents (34%) followed by the category of analgesics, antipyretics, and antirheumatics (23%). The most frequently occurring primary diagnosis requiring hospitalization resulted from poisoning by benzodiazepine-based tranquilizers - Chlordiazepoxide, Diazepam, Flurazepam, Lorazepam, Medazepam and Nitrazepam (19%), Antidepressants - Amitriptyline, Imipramine and Monoamine oxidase [MAO] inhibitors, (14%) and Aromatic Analgesics - Acetanilid, Paracetamol [acetaminophen] and Phenacetin [acetophenetidin], (14%).

Seventy-nine percent of the patients were admitted from emergency departments/outpatient centers. Other sources for admittance include routine (15%), transfer (4%) and other (2%). The types of admission for the majority of the patients was emergency (68%) followed by urgent (21%). Fifty-seven percent of the patients were hospitalized for one day (mean=2; median=1; range=0 to 44). Critical Care days during hospitalization ranged from 0 to 44 days with 52% of the patients requiring one day of critical care.

Regarding youth suicide attempts, there were 24% (219) Hoosiers age 12-21 who were hospitalized for injury during the first six months of 2002. When reviewing the means by which they attempted suicide, there were minimal differences compared to the overall total age group. The category of analgesics, antipyretics andantirheumatics (38%)was the leading mechanism for suicide attempts in this age group while in the overall age group this was the second leading mechanism (23%).

Table 2. Primary Payor of Hospitalization,IndianaHospital Discharge Data, 2002 (Quarter 1 and 2)

(Source: Indiana State Department of Health, Injury Prevention Program)

Table 3: Five Most Frequently Reported ICD-9-CM Classification Codes Among Persons Who Attempted Suicide, Indiana Hospital Discharge Data, 2002 (Quarter 1 and 2)

(Source: Indiana State Department of Health, Injury Prevention Program)

(ICD-9-CM CODE Description Source: 2003 Annual Hospital Version: The Educational Annotation of ICD-9-CM (See Reference section for complete citation)

Table 4: Summary of ECODE Distribution for Suicide (E950-E959), Indiana Hospital Discharge Data, 2002 (Quarter 1 and 2)

(Data Source: Indiana State Department of Health, Injury Prevention Program)

(ECODE Description Source: 2003 Annual Hospital Version: The Educational Annotation of ICD-9-CM (See Reference section for complete citation)

Note: ECODES are not mutually exclusive.

*Indicate circumstances classifiable to E950-E958 as the cause of death or disability from late effects, which are themselves classifiable elsewhere. The “late effects” include conditions reported as such, or as sequelae, which may occur at any time after the attempted suicide or self-inflicted injury.

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