Abstract
Background: Among patients with trauma, those with self-harm exhibit different characteristics than those who experience general accidents. Unstable vital signs following a severe injury often limit accurate imaging and injury assessment during initial treatment, rendering decision-making challenging for definitive care. Identifying correlations between damage area and severity can improve predictions and treatment decisions. We identify differences in characteristics of trauma between patients who experienced general accidents and those who attempted suicide. Methods: This study investigates differences in trauma characteristics between accidental and self-harm injuries in a single-center cohort of 10,180 patients (2015-2023). We analyzed age, sex, trauma mechanism, intention of suicide, Abbreviated Injury Scale (AIS) score, injury severity score (ISS), and height for falls. We divided intentionality into accident and self-harm and analyzed and compared their characteristics. Results: The self-harm group was significantly younger (mean: 10 years younger, p < 0.05) and had a higher proportion of falls (41.0%) and stab injuries (48.9%). Self-harm falls were more severe, with a mean fall height of 10.8m (vs. 4.14m in the accidental group, p < 0.001), resulting in a higher ISS (18.6 vs. 15.5, p < 0.05). In the self-harm group, fall attempts were common among teenagers and those in their 20s, while knife injuries were common in individuals in their 40s and 50s. Conclusion: This study confirmed the relationship between the injury mechanism and AIS in patients with trauma. The damaged area and degree of damage differed between the self-harm and accident groups, even with the same mechanism. Understanding these patterns can enhance initial ER assessments and reduce missed injuries in high-risk patients.