The burden of deliberate self-harm on the critical care unit of a peri-urban referral hospital in the Eastern Cape: A 5-year review of 419 patients

Background. Buffalo City Municipality (BCM) in the Eastern Cape (EC) has the highest susceptibility to deliberate self-harm (DSH) of any South African city. The EC also has a shortage of critical care beds. Objective. This study reviewed DSH admissions over 5 years to the critical care unit (CCU) of Cecilia Makiwane Hospital (CMH), a large peri-urban hospital in the EC. It also examined the financial burden that DSH exerts on public-sector critical care. Methods. DSH cases admitted to CMH’s CCU between January 2006 and December 2010 were retrospectively reviewed. Patients under 13 years of age were excluded. Age, gender, admission duration, agent used, outcome and toxicology results were recorded. Cost was estimated using the Department of Health 2012 fee schedule. Results. A total of 419 patients, comprising 17% of total CCU admissions, were included in the study. Cholinesterase inhibitors (CIs) were the most common agents ingested (55%). Compared with non-CI groups, CI patients where admitted for twice as long from admission to discharge (