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 9-month period in 1985–1986. 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 sixfold and for probable suicides 17-fold when compared with 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.