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Table 4 Characteristics associated with predictive value based on physician diagnoses: intentional self-harm treated in EDs

From: Multi-site medical record review for validation of intentional self-harm coding in emergency departments

 

Maryland

N = 225

Colorado

N = 246

Massachusetts

N = 367

Positive

(n = 202)

%

Negative

(n = 23)

%

Positive

(n = 226)

%

Negative

(n = 20)

%

Positive

(N = 357)

%

Negative

(N ≤ 11)

%

Variables from the medical record

Mean age (SD)a

28.5 (15.3)

28.6 (14.3)

28.6 (14.4)

28.4 (13.3)

29.5 (14.02)

Femalea

51.5

34.8

58.4

61.3

Acute injuryb

71.3

34.8

56.2

95.8

Drug poisoning mechanismc

40.0

43.5

53.1

60.0

43.1

Cut/pierce mechanismc,d

34.0

13.0

28.8

37.5

Suicidal ideation

61.4

60.9

80.5

65.0

52.4

Risk evaluation and used an assessment tool

63.4

47.8

64.6

65.0

44.1

Safety or counseling plan

76.9

70.0

93.4

90.0

81.8

Personal history of self-harm

54.0

54.5

56.2

70.0

56.3

Prior psychiatric hospitalizatione

31.8

40.9

27.4

34.7

Mental health therapy and/or medication

55.9

56.5

61.1

70.0

60.8

Blood alcohol 80 + mg/100 ml (among tested)f

15.9

21.4

18.0

62.7

Drugs other than alcohol

39.0

60.9

51.8

25.8

2 or more personal factors or circumstances

85.1

73.9

86.3

85.0

86.0

Variables from ED billing record

 Drug poisoning codesc,g

n/a

n/a

61.2

72.2

40.6

 Cut/pierce codesc,g

n/a

n/a

26.5

36.7

 Suicidal ideation (R45.851 code)

n/a

n/a

23.0

18.8

 Personal history of self-harm (Z91.5 code)

n/a

n/a

12.8

5.0

 Unspecified suicide attempt (T14.91 code)

n/a

n/a

12.8

9.6

 Not discharged homeh

n/a

n/a

63.5

51.0

  1. % percentage, SD standard deviation, n/a not available, —Censored per data use agreement; CI confidence interval
  2. aColorado and Massachusetts: information from the ED billing record, not the medical record
  3. bMaryland: odds ratio 4.7 (95% CI 1.9–11.6)
  4. cIf a person attempted a drug overdose and cut/pierce on the same occasion that person is counted twice, once in each category
  5. dMaryland: odds ratio 3.4 (95% CI 1.0–12.0)
  6. eMaryland: N = 22
  7. fColorado: N = 196 Maryland: N = 14 Massachusetts: N = 51
  8. gColorado missing n = 32 or 13% of 246
  9. hColorado missing n = 4