Traumatic Self-Harm in Older People: A 7-Year Descriptive Analysis from a London Major Trauma Centre (Sampson, 2025)

Thompson, Joseph H.S, Sivapathasuntharam, Dhanupriya, Cole, Elaine, Sampson, Elizabeth L 

In Injury June 2025

Available online at this link

Suicide in older people is increasing. We know less about serious deliberate self-harm in this population or the impact of this on Major Trauma Centres (MTC).Objectives Investigate demographics, injury mechanism and outcomes in older people admitted with self-inflicted injury.Design Retrospective service evaluation.Setting Single MTC in London, UK.Subjects 60 people aged 65 years and over admitted to a MTC with self-inflicted injury.Methods Retrospective analysis of trauma registry data (February 2015-2022). Variables: age, sex, past medical/ psychiatric history, home and marital status, injury type and narrative, injury severity score (ISS), critical care admission, length of stay, discharge status and destination.Results Self-inflicted injury represented 1.5% of trauma admissions aged 65 and over (80% male, median age 73 years). Most females and over half of men had a psychiatric history (females n = 11, 91.7%; males n = 28, 58.3%). Depression was the most common psychiatric comorbidity (n = 15). Males were more likely to suffer penetrating injury (males n = 37, 77.1%; females n = 4, 33.3%). The most common injury mechanism was self-stabbing amongst males (n = 37, 77.1%) and a jump from height amongst females (n = 6, 50.0%). Median ISS (8.5) and mortality (n = 8, 13.3%) was low across the cohort. The most common discharge destination was psychiatric admission (males n = 28, 58.3%; females n = 6, 50.0%).Conclusion Older people who present with traumatic self-inflicted injury are predominantly male, utilise violent methods, have significant psychiatric comorbidity and require psychiatric admissions.