The Epidemiology of Genitourinary Self-inflicted Injuries: Analysis of the National Trauma Databank

Nizar Hakam; Umar Ghaffar; Behzad Abbasi; Kevin D Li; Adrian Fernandez; Hiren V Patel; Joseph Cuschieri; Benjamin N Breyer

doi:10.1016/j.urology.2024.09.042

The Epidemiology of Genitourinary Self-inflicted Injuries: Analysis of the National Trauma Databank

Urology. 2024 Sep 30:S0090-4295(24)00848-3. doi: 10.1016/j.urology.2024.09.042. Online ahead of print.

Authors

Nizar Hakam¹, Umar Ghaffar¹, Behzad Abbasi¹, Kevin D Li¹, Adrian Fernandez¹, Hiren V Patel¹, Joseph Cuschieri², Benjamin N Breyer³

Affiliations

¹ Department of Urology, University of California San Francisco, San Francisco, CA.
² Department of Surgery, University of California San Francisco, San Francisco, CA.
³ Department of Urology, University of California San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA. Electronic address: [email protected].

PMID: 39357577
DOI: 10.1016/j.urology.2024.09.042

Abstract

Objective: To provide insight into the epidemiologic characteristics and trends of genitourinary (GU) self-inflicted injury (SII).

Methods: We used data from the National Trauma Databank between 2017 and 2020. We described the characteristics of GU SII cases based on injured organ and then compared male and female injuries.

Results: We identified 56,463 patients with SII, of which 1508 (2.7%) had GU involvement. Most cases were male patients (77.3%) and white (70.6%). Median age was 35 years (IQR 26-50). The most commonly injured GU organs were kidney (43.4%), followed by scrotum/testes (22.5%), and penis (18.2%). Most cases (89.9%) represented a single-organ injury whereas 10.1% had 2 or more GU organs injured. Seventy-three of those with kidney injuries (11.2%) underwent nephrectomy. Only 1 patient performing GU SII had a diagnosis code for transsexualism but the majority (82.2%) suffered from pre-existing conditions of which 20.5% had 3 or more comorbidities. More than half the population (54.9%) had preexisting diagnosed mental or personality disorder. A non-GU co-injury was present in most cases (70.8%), most commonly affecting another abdominal organ (44.3%) or fractures (41.3%). A positive drug screen was found in 30.7% of cases. Most patients survived though 15.4% died. Ninety-four percentage of fatal cases had a concomitant non-GU injury.

Conclusion: GU injuries account for 2.6% of all SII. These patients are often young white males with known mental or personality disorders. Kidneys were the most common injured and mortality was highest in cases of kidney and bladder injuries with multi-organ trauma involving non-GU organs.