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Purola L, Vuola J, Palmu R. Self-harm in burn patients: An analysis of Finnish patient records (2011-2020). Burns 2024; 50:1083-1090. [PMID: 38538444 DOI: 10.1016/j.burns.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 05/25/2024]
Abstract
AIM To collect data on self-harm burn patients at a national level in Finland and analyze patient characteristics. MATERIAL AND METHODS First, we went through The National Care Register for Health Care (Hilmo) records from 2011 to 2015 to find all patients in Finland with both burn and self-harm ICD10 codes. Then we investigated the medical records of all patients treated at the National Burn Centre (NBC) in Helsinki in the period 2011-2020. Patients admitted to the hospital because of self-harm burn injuries were compared to those without self-harm injuries. Patients below 18 years old were excluded. RESULTS The Hilmo register consisted of a total of 3391 adult burn patients admitted to any healthcare unit during the study period. Compared with non-self-harm patients, self-harm patients (N = 82) had lower mean age (41 years vs 54 years, p < 0.001) and longer hospitalization (18 days vs. 6 days, p < 0.05). Two-thirds of the self-harm patients (N = 38) admitted to the NBC in the period 2011-2020 had a pre-burn history of psychiatric care (66%) and one-third of them had a previous record of self-harm or suicide attempt. Men had more severe burns than women (mean TBSA 46% vs. 14%, p < 0.05), and seven of them died during the first 48 h of care, but this was not the case for any female patient. CONCLUSIONS Self-harm burn patients were younger and had longer hospitalization at all care levels than other burn patients. Based on medical records of hospitalized self-harm burn patients, we found clear gender differences in the severity of the burn injury and in mortality, with men suffering more severe injuries, in some cases leading to death. Recognizing high-risk patients pre-burn could have a strong preventive impact.
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Affiliation(s)
- Lotta Purola
- Department of Plastic Surgery, Oulu University Hospital, PO. Box 21, 90029 Oulu, Finland; Department of Plastic Surgery, Helsinki Burn Centre, Helsinki University Hospital, University of Helsinki, P.O. Box 800 FIN - 00029 HUCH, Helsinki, Finland.
| | - Jyrki Vuola
- Department of Plastic Surgery, Helsinki Burn Centre, Helsinki University Hospital, University of Helsinki, P.O. Box 800 FIN - 00029 HUCH, Helsinki, Finland
| | - Raimo Palmu
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 590 (Välskärinkatu 12), FIN - 00029 HUS, Finland; Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), P.O. Box 30 (Mannerheimintie 166), FI-00271 Helsinki, Finland
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2
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Pompermaier L, Steinvall I, Elmasry M, Eladany MM, Abdelrahman I, Fredrikson M, Sjöberg F. Long-term mortality after self-inflicted burns. Burns 2024; 50:252-261. [PMID: 37805374 DOI: 10.1016/j.burns.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Those with self-inflicted burns are a small but consistent group among burn patients, with large injuries and conflicting findings regarding their in-hospital mortality. Overall, burn survivors have a shorter life expectancy, as compared with national controls, but long-term mortality after self-inflicted burns is understudied. The aim of this retrospective study was to investigate possible differences in long-term mortality among survivors after self-inflicted and accidental burns. METHODS All adult patients with burns admitted at the Linköping Burn Centre and discharged alive between 2000 and 2017 were included, and end of follow up was April 26, 2021. Those with unknown survival status at that time were excluded. A Cox proportional hazards regression model, adjusted for age and sex, was used to analyse long term mortality. RESULTS Among the 930 patients included in this study, 37 had self-inflicted burns. Overall, median follow up period was 8.8 years and crude mortality was 24.7%. After adjustment for age and sex, self-inflicted burns were independently associated with long-term mortality, Hazard Ratio= 2.08 (95% CI 1.13-3.83). Post hoc analysis showed that the effect was most pronounced during the first years after discharge although it was noticeable over the whole study period. CONCLUSION Long-term risk of mortality after discharge from a burn centre was higher in patients with self-inflicted burns than in patients with accidental burns. The effect was noticeable over the whole study period although it was most pronounced during the first years after discharge.
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Affiliation(s)
- Laura Pompermaier
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden.
| | - Ingrid Steinvall
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden
| | - Moustafa Elmasry
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden
| | - Mostafa M Eladany
- Department of Anesthesiology & Intensive Care, Faculty of Medicine, Suez Canal University, Egypt
| | - Islam Abdelrahman
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden
| | - Mats Fredrikson
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Folke Sjöberg
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden; Department of Anaesthesiology and Intensive Care, Linköping University, Linköping, Sweden
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3
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Amirize E, Kankam HKN, Abdulsalam A, Choudhary R, Walker H, Moiemen N. Self-inflicted Burns: The Experience of a UK Regional Burns Center. J Burn Care Res 2024; 45:80-84. [PMID: 37864840 PMCID: PMC11023247 DOI: 10.1093/jbcr/irad163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Indexed: 10/23/2023]
Abstract
Self-inflicted burns (SIBs) are preventable injuries that often occur due to suicidal intent or deliberate self-harm. The incidence of SIB and demographics vary across different countries. This study highlights our regional experience of SIB over almost 2 decades, assessing characteristics and outcomes. A retrospective chart review of all patients assessed at a UK regional burns center, presenting with SIB, from 2003 to 2021, was performed. Subgroup analyses based on gender, the presence or absence of pre-existing psychiatric disorders, and in-hospital patient mortality were undertaken. The relationship between annual mental health funding and the incidence of SIB was assessed. Over the study period, a total of 285 SIB cases, with a median age of 42.84 years, were presented to our center. The majority of patients were male (63.2%) and had a pre-existing psychiatric disorder (74.7%). Flame burns were the most frequent type of injury (82.1%) and the median total BSA (TBSA) was 10.25%. The average length of hospital stay was 10 days and the inpatient mortality rate was 20.7%, significantly greater than the mortality of the rest of the cohort (3.7%, P < .01). SIB survivors were younger and had less severe burns, relative to non-survivors. There was no statistically significant correlation between the incidence of SIBs and mental health funding. SIBs account for a minority of referrals to our regional burns center. Adequately funded regional and national measures should be implemented to reduce the incidence and impact of these injuries, alongside appropriate mental health support.
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Affiliation(s)
- Ezekwe Amirize
- Department of Burns and Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, UK
- Scar Free Foundation Centre for Burns Research, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, UK
| | - Hadyn K N Kankam
- Department of Burns and Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, UK
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Abdulrazak Abdulsalam
- Department of Burns and Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, UK
- Scar Free Foundation Centre for Burns Research, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, UK
| | - Rajan Choudhary
- Department of Burns and Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, UK
| | - Harriet Walker
- Department of Burns and Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, UK
| | - Naiem Moiemen
- Department of Burns and Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, UK
- Scar Free Foundation Centre for Burns Research, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2WB, UK
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
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4
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Kobarg BS, Guanilo MEE, Bernard GP, Barreto MGP, Vana LPM, de Oliveira Junior JL, de Araújo KD, de Lauro Machado Homem R, Marlene Tecla E, de Arruda FCF, Adorno J, Gragnani A, José Lopes Pereima M. NATIONAL MULTICENTRIC STUDY ON THE INCIDENCE OF ALCOHOL BURNS DURING THE COVID-19 PANDEMIC. Burns 2022; 49:615-621. [PMID: 35610078 PMCID: PMC9026957 DOI: 10.1016/j.burns.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 04/06/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022]
Abstract
Background Objectives Method Results Conclusions
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5
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Saavedra PAE, De Oliveira Leal JV, Areda CA, Galato D. The Costs of Burn Victim Hospital Care around the World: A Systematic Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:866-878. [PMID: 34183945 PMCID: PMC8223566 DOI: 10.18502/ijph.v50i5.6104] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/22/2020] [Indexed: 12/02/2022]
Abstract
BACKGROUND Burn injuries are very common and fire-related burns account for over 300,000 deaths per year globally. The costs of the treatment of these patients change around the world. The aim of the present study was to conduct a systematic literature review to identify the costs related to hospital stays of burn victims in countries with different Human Development Index (HDIs). METHODS PubMed, CINAHL and BVIS databases were searched using the following terms: "burn," treatment" and "costs". The review included articles that presented cost studies or economic assessments of burn victims in which the costs were reported, and published between 2012 and 2019. The quality of the evidence was assessed using the Consensus on Health Economic Criteria. This review presents register in Prospero (CRD42019137580). RESULTS The review included 19 economic studies conducted in 13 countries, most with a very high HDIs. Most studies estimated direct acute burn care costs through bottom-up costing and institutional data. Total hospital care costs ranged from US$ 10.58 to US$ 125,597.86 per patient, the cost of 1% of total body surface area burned ranged from US$ 2.65 to US$ 11,245.04, and the cost of hospital care per day, from US$ 24.23 to US$ 4,125.50. CONCLUSION The costs are high and show wide discrepancies among countries. Medical costs and other losses caused by fatal and non-fatal burn injuries differ considerably among demographic groups, care protocols, and country HDIs.
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Affiliation(s)
- Pamela Alejandra Escalante Saavedra
- Health Sciences and Technology Post-Graduate Program, University of Brasilia, Brasília, Distrito Federal, Brazil
- Research Group on Access to and Responsible Use of Medications, University of Brasilia, Brasília, Distrito Federal, Brazil
| | | | - Camila Alves Areda
- Research Group on Access to and Responsible Use of Medications, University of Brasilia, Brasília, Distrito Federal, Brazil
- Pharmacy Graduate, University of Brasilia, Brasília, Distrito Federal, Brazil
| | - Dayani Galato
- Health Sciences and Technology Post-Graduate Program, University of Brasilia, Brasília, Distrito Federal, Brazil
- Research Group on Access to and Responsible Use of Medications, University of Brasilia, Brasília, Distrito Federal, Brazil
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6
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Abrams TE, McGarity SV. Psychosocial Determinants of Burn-Related Suicide: Evidence From the National Violent Death Reporting System. J Burn Care Res 2021; 42:305-310. [PMID: 32842149 DOI: 10.1093/jbcr/iraa152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Suicide is a unique phenomenon in humans. In 2017, over 47,000 Americans died by suicide, prompting a public health crisis. Suicide by burning, while one of the rarest forms of suicide, could be mitigated in part by early recognition and treatment of the underlying psychosocial factors. To date, investigators have attempted to tease out the risk factors associated with this phenomenon through the examination of burn center chart reviews and repository data, but these studies were limited by small sample sizes. In order to fill this gap in the literature, the authors analyzed 14 years of data (2003-2016) from the National Violent Death Reporting System. Suicides by burning (n = 722) were compared with a reference group containing all other suicide types (n = 166,949). Socio-demographic variables and psychosocial factors (eg, mental health, substance use, and alcohol use) were included in the model. Due to the imbalance between the target and reference groups, rare event data analysis was used to reduce potential small sample estimation bias. Results indicated that females (OR = 1.6, 95% CI: .50-2.83, P < .001), Caucasians (OR = 1.7, 95% CI: 1.1-2.7, P < .001), victims with schizophrenia (OR = 5.4, 95% CI: 3.7-7.8, P < .001), and victims with eating disorders (OR = 5.6, 95% CI: 1.9-8.6, P < .001) are significantly more likely to commit suicide by burning. These results contribute new knowledge to what is currently known about suicidal burn-related behaviors and supports interventions that focus on mitigating this insidious public health problem.
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Affiliation(s)
- Thereasa E Abrams
- College of Social Work, The University of Tennessee-Knoxville, Nashville
| | - Stephen V McGarity
- College of Social Work, The University of Tennessee-Knoxville, Nashville
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Bahçe ZŞ, Öztaş T. Epidemiological analysis of patients with burns in third-line hospitals in Turkey. Int Wound J 2020; 17:1439-1443. [PMID: 32515905 PMCID: PMC7948584 DOI: 10.1111/iwj.13426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 12/26/2022] Open
Abstract
Burns are a major health problem worldwide. Burn injury resulting from making contact with hot objects, direct or indirect contact with flame, and exposure to chemical agents or electric current is usually preventable. In this study, epidemiological data of the patients who had been hospitalised in the burn unit was assessed. The records of 1453 patients who were admitted to the burn unit of Diyarbakir Gazi Yaşargil Training and Research Hospital between July 2008 and April 2018 were retrospectively examined. Out of 1453 cases, 81.7% (1187) were children and 18.3% (266) were adults, 58.3% of the cases were male (847) and 41.7% (606) were females. Patients had a mean age of 11 ± 5 years (1-81 years). The most common cause of burns was contact with hot liquids (82.86%) while other causes were flame burns (12.04%), electrical contact burn (3.02%) contact with chemical substances (2.06%). Most of the cases were found to have burned 10% to 20% of the body surface. Localization was most frequently seen in the lower extremity and less frequently in the upper limb, trunk, head and neck, and perineal regions. The majority of burn injuries are preventable. Therefore, epidemiological studies in the field of burns will provide vital preventive information to develop strategies to reduce injury frequency and spend on health. Because burns are a social problem, prevention efforts require social co-operation. Promotional meetings in schools are important to increase family-school cooperation to inform children of school age, to give lectures and first aid measures to rural areas.
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Affiliation(s)
- Zeynep Şener Bahçe
- Department of General Surgery, Gazi Yaşargil Training and Research HospitalUniversity of Health SciencesDiyarbakirTurkey
| | - Tülin Öztaş
- Department of Pediatric Surgery, Gazi Yaşargil Training and Research HospitalUniversity of Health SciencesDiyarbakirTurkey
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8
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How self-inflicted injury and gender impacted the outcome following a severe burn. Burns 2019; 45:621-626. [DOI: 10.1016/j.burns.2018.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/30/2018] [Accepted: 10/23/2018] [Indexed: 11/22/2022]
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9
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Laughon SL, Gaynes BN, Chrisco LP, Jones SW, Williams FN, Cairns BA, Gala GJ. Burn recidivism: a 10-year retrospective study characterizing patients with repeated burn injuries at a large tertiary referral burn center in the United States. BURNS & TRAUMA 2019; 7:9. [PMID: 30923714 PMCID: PMC6423767 DOI: 10.1186/s41038-019-0145-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/12/2019] [Indexed: 11/30/2022]
Abstract
Background Psychiatric and substance use disorders are common among trauma and burn patients and are known risk factors for repeat episodes of trauma, known as trauma recidivism. The epidemiology of burn recidivism, specifically, has not been described. This study aimed to characterize cases of burn recidivism at a large US tertiary care burn center and compare burn recidivists (RCs) with non-recidivists (NRCs). Methods A 10-year retrospective descriptive cohort study of adult burn patients admitted to the North Carolina Jaycee Burn Center was conducted using data from an electronic burn registry and the medical record. Continuous variables were reported using medians and interquartile ranges (IQR). Chi-square and Wilcoxon-Mann-Whitney tests were used to compare demographic, burn, and hospitalization characteristics between NRCs and RCs. Results A total of 7134 burn patients were admitted, among which 51 (0.7%) were RCs and accounted for 129 (1.8%) admissions. Of the 51 RCs, 37 had two burn injuries each, totaling 74 admissions as a group, while the remaining 14 RCs had between three and eight burn injuries each, totaling 55 admissions as a group. Compared to NRCs, RCs were younger (median age 36 years vs. 42 years, p = 0.02) and more likely to be white (75% vs. 60%, p = 0.03), uninsured (45% vs. 30%, p = 0.02), have chemical burns (16% vs. 5%, p < 0.0001), and have burns that were ≤ 10% total body surface area (89% vs. 76%, p = 0.001). The mortality rate for RCs vs. NRCs did not differ (0% vs. 1.2%, p = 0.41). Psychiatric and substance use disorders were approximately five times greater among RCs compared to NRCs (75% vs. 15%, p < 0.001). Median total hospital charges per patient were nearly three times higher for RCs vs. NRCs ($85,736 vs. $32,023, p < 0.0001). Conclusions Distinct from trauma recidivism, burn recidivism is not associated with more severe injury or increased mortality. Similar to trauma recidivists, but to a greater extent, burn RCs have high rates of comorbid psychiatric and medical conditions that contribute to increased health care utilization and costs. Studies involving larger samples from multiple centers can further clarify whether these findings are generalizable to national burn and trauma populations.
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Affiliation(s)
- Sarah L Laughon
- 1Department of Psychiatry, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599-7160 USA
| | - Bradley N Gaynes
- 1Department of Psychiatry, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599-7160 USA
| | - Lori P Chrisco
- Department of Surgery, 4001 Burnett-Womack Building, CB #7050, Chapel Hill, NC 27599-7050 USA
| | - Samuel W Jones
- Department of Surgery, 4001 Burnett-Womack Building, CB #7050, Chapel Hill, NC 27599-7050 USA.,North Carolina Jaycee Burn Center, 101 Manning Drive, CB #7206, Chapel Hill, NC 27599-7600 USA
| | - Felicia N Williams
- Department of Surgery, 4001 Burnett-Womack Building, CB #7050, Chapel Hill, NC 27599-7050 USA.,North Carolina Jaycee Burn Center, 101 Manning Drive, CB #7206, Chapel Hill, NC 27599-7600 USA
| | - Bruce A Cairns
- Department of Surgery, 4001 Burnett-Womack Building, CB #7050, Chapel Hill, NC 27599-7050 USA.,North Carolina Jaycee Burn Center, 101 Manning Drive, CB #7206, Chapel Hill, NC 27599-7600 USA
| | - Gary J Gala
- 1Department of Psychiatry, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599-7160 USA
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Mushin OP, Esquenazi MD, Ayazi S, Craig C, Bell DE. Self-inflicted burn injuries: Etiologies, risk factors and impact on institutional resources. Burns 2019; 45:213-219. [DOI: 10.1016/j.burns.2017.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 10/27/2022]
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Atwell K, Bartley C, Cairns B, Charles A. Incidence of self-inflicted burn injury in patients with Major Psychiatric Illness. Burns 2018; 45:615-620. [PMID: 30429073 DOI: 10.1016/j.burns.2018.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/05/2018] [Accepted: 10/17/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Psychiatric disorders are mental illnesses that impair judgment, thought process and mood that can result in physical and emotional disability. According to DSM-IV, mental disorders increases risk of traumatic injury, particularly burn [1] (American Psychiatric Association, 2013). However, there are few studies that look at patients with pre-existing major psychiatric disorders and burn outcomes. We aim to assess the incidence and intentionality of burn injury in patients with pre-existing psychiatric disorders. METHODS This is a retrospective study of patients admitted to the UNC Jaycee Burn Center from 2002 to 2015 and entered in the burn registry. Variables analyzed include basic demographics, insurance status, total body surface area (TBSA) of burn, Charlson comorbidity index (CCI), burn etiology, presence of inhalation injury, burn circumstance, intensive care unit (ICU) and hospital length of stay (LOS) and mortality. Chi-square, Analysis of Variance (ANOVA), Kruskal-Wallis test and Multivariate logistic regression was used to analyze the data. RESULTS 11,650 adult and pediatric patients were entered in the burn registry from 2002 to 2015 and 494 (4.2%) adult and pediatric patients had preexisting major psychiatric illness (MPI). Within the large cohort of admitted burn patients, 90 (0.8%) patients presented with self-inflicted burn injuries. 41% of patients with SIB (n=37/90) had MPI. The incidence of self-inflicted burn injury (SIB) within the MPI (n=494) cohort was 7.5% (n=37). Mean age of patients with and without self-inflicted burn injury was 35.3 (±11.6) vs. 41.8 (±17.3), respectively. Mean TBSA was significantly higher in patient with SIB at 18.6 (±16.5) vs. 8.5(±12.2) p<0.001. Non-white race had significantly higher rate of SIB compared to white cohort. There was no significant difference in mortality rates between SIB and Non-SIB (5.4% vs. 3.7%, p=0.609), respectively. Median Hospital LOS was significantly increased in patients with SIB compared to NSIB 31 (IQR=55) vs. 9 (IQR=20) days, p=0.004. Multivariate logistic regression for predictors of self-inflicted burn injury showed that minorities were more likely to incur self-inflicted burn injury among patients with major psychiatric illnesses. CONCLUSION The incidence of self-induced burn injury in patients with MPI is low and of all the self-inflicted burn patients, 60% did not have a major psychiatric illness identified. Our findings emphasize the importance of identifying patients with MPI with or without self-induced injury that may benefit from more extensive psychiatric screening after burn and counseling, particularly minority patients as they may benefit from additional mental health counseling following severe burn.
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Affiliation(s)
- Kenisha Atwell
- Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States
| | - Colleen Bartley
- Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States
| | - Bruce Cairns
- Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States
| | - Anthony Charles
- Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States.
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Li F, Coombs D. Mental health history-a contributing factor for poorer outcomes in burn survivors. BURNS & TRAUMA 2018; 6:1. [PMID: 29637081 PMCID: PMC5887169 DOI: 10.1186/s41038-017-0106-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 12/27/2017] [Indexed: 11/10/2022]
Abstract
Background A pre-morbid mental health history is common in patients with severe burn injuries. This creates challenges in providing rehabilitation. The aim of this study is to cross examine the possible impact of psychological co-morbidities on outcomes. Methods A notes audit was carried out examining patients that were admitted to Concord Hospital Burns Unit in a 3-year period (2010-2012). Patients with total body surface area (TBSA) of 20% or greater and aged between 16 and 50 years were included. Subjects were divided into a mental health group and a control group. SPSS version 21 statistic program was used for analysis the data. Results Data collected included length of stay, time to achieve independence, %TBSA, types of burns and surgery required. Results of 69 files showed that the average length of stay per %TBSA was nearly double in the patients with a mental health problem (1.47 vs 0.88). They also had a higher rate of re-graft (52% vs 22%) due to infection and poor nutrition. The average time for patients to achieve independence in daily living activity was significantly higher (p = 0.046) in the mental health group (36.2 days) versus the control group (24.1 days). Conclusion Patients with a mental health history may have poorer general health. This may result in a higher failure rate of grafting, leading to a requirement of re-graft. Hence, it took a longer time to achieve independence, as well as a longer hospital stay. A mental health history in burn survivors can be a contributing factor for poorer outcomes in the adult population.
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Affiliation(s)
- Frank Li
- Concord Repatriation General Hospital, Sydney, Australia
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Chatelain S, Serror K, Chaouat M, Mimoun M, Boccara D. Immolation dans notre centre de traitement des brûlés de 2011 à 2016. ANN CHIR PLAST ESTH 2018; 63:41-46. [DOI: 10.1016/j.anplas.2017.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 11/27/2017] [Indexed: 11/30/2022]
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Sayma M, Booth S, Weller D, Dheansa B. A retrospective study: Can we differentiate between repeat self-inflicted burn patients and those who commit a self-inflicted burn as an individual occurrence? J Plast Reconstr Aesthet Surg 2017; 70:1675-1680. [DOI: 10.1016/j.bjps.2017.05.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/06/2017] [Accepted: 05/31/2017] [Indexed: 10/19/2022]
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A 10 year epidemiological study of paediatric burns at the Welsh Centre for burns and plastic surgery. Burns 2016; 43:632-637. [PMID: 27816410 DOI: 10.1016/j.burns.2016.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 10/02/2016] [Accepted: 10/04/2016] [Indexed: 11/22/2022]
Abstract
Paediatric burns make up a significant proportion of burn injured patients seen within the hospital setting and worldwide account for a significant proportion of unintentional deaths. Currently there is limited data on severe paediatric burns requiring intensive care support. Our study aimed primarily to describe the epidemiology of severe burns admitted to the intensive care unit at our centre receiving fluid resuscitation over a 10 year period. A secondary aim was to describe the referrals patterns in general over the same time period. A retrospective analysis was performed for paediatric patients referred to our centre receiving fluid resuscitation and intensive care support from 2003 to 2013. We also analysed the patterns of referrals, admissions and need for surgical intervention over the same time period retrospectively. Children less than 5 years old made up 65% of admissions to intensive care and scald injuries (56%) were the commonest aetiology. Both total length of stay (25 days in 2003 to 10 days in 2013) and intensive care length of stay (7.2 days in 2003 to 3 days in 2013) decreased during the study and less patients underwent operative intervention. Referrals to our centre increased from 261 in 2003 to 366 in 2013, however admission rates declined from 145 to 85 during that time period. Currently there is limited data on severe burns within the paediatric population. Our study provides epidemiological data in this area, an important step for developing future prevention strategies.
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Gaucher S, Baylé FJ, Magne J. Self-inflicted burns: Are they preventable injuries? Burns 2016; 42:1158-1159. [PMID: 27180601 DOI: 10.1016/j.burns.2016.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 03/09/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Sonia Gaucher
- Université Paris Descartes, Paris Sorbonne Cité, 75006 Paris, France; Service de chirurgie générale, Plastique et ambulatoire, AP-HP, HUPC, Hôpital Cochin, 75014 Paris, France.
| | - Franck J Baylé
- Université Paris Descartes, Paris Sorbonne Cité, 75006 Paris, France; Centre Hospitalier Sainte-Anne, 75014 Paris, France
| | - Jocelyne Magne
- Service des grands brûlés, AP-HP, HUPC, Hôpital Cochin, 75014 Paris, France
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