Injury patterns of suicide attempts in the head and neck area-a retrospective analysis over 15 years

Purpose: Suicide attempts may involve various parts of the body with different severity grades and therefore represent a multidisciplinary challenge. The head and neck region is highly vulnerable to severe self-inflicted injuries, yet literature on this topic remains limited.

Methods: A retrospective analysis was performed of patients with suicide attempts in an Otorhinolaryngology (ORL) department of a tertiary referral hospital over a 15-year period. The aim of the study was to analyse their clinical course and injury patterns.

Results: 70 patients were included (m: 42/70; f: 28/70). The mean age at suicide attempt was 43.7 years. Women were significantly younger than men (p = 0.046). Seven injury types were differentiated: strangulation (44.3%), stabbing (17.1%), jumping from a height and firearm use (10.0% each), jumping in front of a moving vehicle and ingestion of acids/bases (7.1% each) as well as ingestion of pills (4.3%). Men were dominantly involved in strangulation (14/42; 33.3%) and stabbing (11/42; 26.2%), whereas women appeared with strangulation (17/28; 60.7%) and tablet ingestion (3/28; 10.7%). Men required ORL-specific surgical care significantly more often than women (43.9% vs. 7.1%; p < 0.001). Men chose "violent" methods more frequently than women (90.5% vs. 46.4%; p < 0.001). Women were more likely to receive psychiatric treatment (p = 0.0011).

Conclusions: Violent suicide attempts were more common in males and therefore required more often surgical intervention. Soft attempts and psychiatric diagnoses were more often associated with female gender. Routine laryngoscopy is recommended within 24h after the initial trauma. All individuals were successfully treated in an interdisciplinary setting and survived with moderate morbidity.