Objective To determine whether the increased restrictions, isolation and stressors associated with COVID-19 led to an increase in rates or severity of self-immolation burn injuries. Design Retrospective review of a prospectively-collected database of New South Wales burn patients, comparing 2020 data with the preceding 5 years. Setting Both adult units in the New South Wales Statewide Burn Injury Service (Concord Repatriation General Hospital and Royal North Shore Hospital). Participants All adult patients in New South Wales with self-inflicted burn injuries between 1st January 2015 and 31st December 2020. Outcome measures Demographic information, precipitating factors, burn severity, morbidity and mortality outcomes. Results There were 18 episodes of self-immolation in 2020, compared to an average of 10 per year previously. There were statistically significant increases in burn size (43% total body surface area vs 28%) and revised Baux score (92 vs 77). Most patients had a pre-existing psychiatric illness. Family conflict and acute psychiatric illness were the most common precipitating factors. Conclusion 2020 saw an increase in both the frequency and severity of self-inflicted burn injuries in New South Wales, with psychiatric illness a major factor.
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