Identification of Youth who have Deliberately Self Poisoned – A Medical Records Audit in University Teaching Hospitals

A descriptive, cross sectional, retrospective audit of admission records and hospital casualty cards were undertaken to determine the accuracy of identification of cases of deliberate self-poisoning (DSP) among youth admitted and presenting for self poisoning. To investigate the rate of admission for poisoning presentations. From 1,260 cases of poisoning, aged 10–25 years, admitted to three university teaching hospitals in Sydney during 1991 to 1994, a sample of 167 medical record files was reviewed. From 11,100 presentations of 10–25 year olds to the emergency rooms of two of these hospitals in the same period, a random sample of 1,200 was reviewed. The diagnostic code of Deliberate Self Poisoning (DSP) admissions is low in sensitivity (50% were wrongly coded as accidental) and high in specificity (only one was wrongly coded as deliberate). Alcohol overdose, lack of DSP identification, and past or present history of a mental health problem were associated. The misclassification rate if generalizable to other settings, suggests that DSP admission rates may be underestimated by 100%.