All-cause mortality after non-fatal self-poisoning : a cohort study

Background: Suicide has been repeatedly shown to have greatly increased incidence after non-fatal self-harm but far less is known about early death from other causes. The present study's aim was to describe mortality and risk factors concerning all causes of death after non-fatal self-poisoning. Methods: A prospective cohort study of 976 patients who attended the Emergency Department in Nottingham, UK during a nine-month period in 1985-86. Information on deaths was obtained for 16 years following an episode of self-poisoning, from the records of the Office for National Statistics. Results: The observed:expected ratio for all-cause mortality was 2.2. Deaths due to diseases of the digestive and respiratory systems were respectively 4.4 and 2.9 times more frequent than expected. The risk for accidents was 6-fold and for probable suicides 17-fold compared to the risk in the general population. The main risk factor for subsequent deaths from natural causes was increasing age. Conclusions: The findings of this study suggest that patients who survive self-poisoning have an increased risk of death from natural and unnatural causes. The findings point towards the need for more effective clinical management and preventive initiatives