34 Penetrating neck trauma and rising rates of deliberate self-harm: A single trauma centre experience

Abstract Background Penetrating Neck Injuries (PNI) is an increasingly encountered presentation in UK emergency departments. Although often the cause of violent assault, the incidence of self-inflicted neck trauma is rising. We aim to review the changing patterns of PNI over a period of 6 years in our Major Trauma Service (MTS). Methods A retrospective review of all cases of adult patients presenting with PNI to Aintree University Hospital (AUH) between Jan 2017 and Jan 2023. Cases were identified through medical coding and review of electronic medical records. Results 71 cases of PNI were managed at AUH between Jan 2017- Jan 2023, representing a 13% increase over previous reports. The proportion of presentations as a result of deliberate self-harm (DSH) was 27% over the previous 6-year period, compared to 51% of all PNIs presenting over the period covered by this report; representing a statistically significant increase of 89% between the two time frames (p = 0.0008). The highest ratio of DSH to total PNI cases occurred during the first wave of COVID-19, with 77% of presentations being self-inflicted. The prevalence of mental health disorders within the cohort increased by 65% during the six years, reaching peak levels at 92% in the year 2020. Conclusion This study highlights the increasing incidence of self-inflicted PNI within the context of increasing prevalence of psychiatric disorders. Rising rates of deliberate self-inflicted neck trauma demonstrates the importance of reallocation of health care resources for health promotion, prevention, and treatment in mental health services.