Early period psychiatric disorders following burn trauma and the importance of surgical factors in the etiology

Abstract

AMAÇYanık travması sonrasında erken dönemde ortaya çıkan psikiyatrik bozukluklar değerlendirildi. GEREÇ VE YÖNTEMYanık travmasına maruz kalan 1369 hastanın dosyası geriye dönük olarak incelendi. Psikiyatrik bozukluk saptanan 45 hasta yaş, cinsiyet, kronik hastalık, yanık öncesindeki psikiyatrik bozukluk, yanık nedeni, yanık yüzdesi, yanık derecesi, ek travma, ameliyat sayısı, hastanede kalış süresi, ekstremite amputasyonu, entübasyon durumu, psikiyatrik semptomlar, travma sonrası psikiyatrik bozukluk ve mortalite açısından değerlendirildi. BULGULARYanık travması sonrası erken dönemde 45 hastada psikiyatrik bozukluk saptandı. Hastaların 7'si (%15,5) kadın, 38'i (%84,5) erkekti. Ortalama yaş 32±14,3 yıl, yanık yüz-desi %40,09±20,69, geçirilmiş ameliyat sayısı 2,95±1,75, hastanede kalış süresi 51.57±38.62 gün idi. Hastaların 12'sinde (%26,6) post travmatik stres bozukluğu (PTSD), 11'inde (%24,4) deliryum, 8'inde (%17,7) anksiyete bozukluğu, 7'sinde (%15,5) depresyon, 1'inde (%2,2) yoksunluk sendromu, 1'inde (%2.2) şizoaffektif bozukluk, 2'sinde (%4,4) PTSD ve depresyon, 2'sinde (%4,4) PTSD ve deliryum ve 1'inde (%2.2) PTSD ve anksiyete bozukluğu görüldü. SONUÇYanık multisipliner yaklaşımla tedavi edilebilen bir travmadır.Anahtar Sözcükler: Yanık; erken tanı; psikiyatrik bozukluk. BACKGROUNDWe aimed to assess early period psychiatric disorders following burn trauma. METHODSThe files of 1369 patients who had burn trauma were analyzed retrospectively. Forty-five patients with the diagnosis of psychiatric disorder were assessed based on the variables of age, gender, presence of chronic diseases, psychiatric disorders prior to burn trauma, cause of the burn, burn percentage, degree of burn, additional trauma, number of surgeries, duration of hospitalization, extremity amputation, intubation status, psychiatric symptoms, post-trauma psychiatric disorders, and mortality. RESULTSForty-five patients developed psychiatric disorder in the early period following burn trauma. Of the 45 patients, 7 (15.5%) were female and 38 (84.5%) were male. The mean age was 32±14.3 years, burn percentage was 40.09±20.69%, number of operations was 2.95±1.75, and the total duration of hospitalization was 51.57±38.62 days. Twelve (26.6%) patients had post-traumatic stress disorder (PTSD), 11 (24.4%) had delirium, 8 (17.7%) had anxiety disorder, 7 (15.5%) had depression, 1 (2.2%) had abstinence syndrome, 1 (2.2%) had schizoaffective disorder, 2 (4.4%) had PTSD and depression, 2 (4.4%) had PTSD and delirium, and 1 (2.2%) had PTSD and anxiety disorder. CONCLUSIONBurn is a trauma that can be treated with a multidisciplinary approach.

Prevalence and Risk Factors for Delirium in Elderly Patients With Severe Burns: A Retrospective Cohort Study

“…The current literature shows a delirium prevalence of 29% and 77% in adults admitted to a burn ICU. 11,12 At two specialized burn centers, delirium was diagnosed in 16% and 39% of the admitted adults. 13,14 Risk factors for delirium have been widely investigated for surgical and nonsurgical populations, but not for burn center patients.…”

Psychiatric Disorders, Delirium and Mortality in Patients Referred for Consultation in a Burn Center: A Four-Year Retrospective Study

“…Similar to our results, anxiety disorder was defined in 14% and acute stress disorder in 5.8% of their patients (26) . Yabanoğlu et al (2012) reviewed the files of 1369 cases, and reported that the rate of psychiatric diagnosis within 15 days after the burn incident was 3.2%, and the diagnoses were PTSD in 26.6%, delirium in 24.4%, anxiety disorder in 17.7%, depression in 15.5% of the patients, respectively (22) . In our study, we observed that 33 patients (19%) died during the four-year period and the majority of this group was diagnosed as delirium (n=14, 42.4%).…”

“…Studies conducted in Turkey examining burns and mental disorders were reviewed, and a study analyzing family characteristics of children and adolescents with corrosive burns and another study evaluating burn related psychiatric disorders in children were identified (20,21) . There was only one study examining psychiatric disorders in the early period in an adult population (22) . Therefore, our study will contribute to the literature in this field.…”

[Hekzan Gazına Bağlı Olarak % 80 Yanık Gelişen ve Greft Uygulanan Bir Hastanın Akut Dönemdeki Hemşirelik Bakımı: Olgu Sunumu

“…Post travmatik stres bozukluğu, anksiyete ve depresyon yanık hastalarının sıklıkla karşılaştıkları sorunlardır (16). Hastanın izlendiği günler içinde bilinci açık ve koopereydi, kendisini tam olarak ifade edebildiği gözlendi.…”

“…Özellikle kadınların yanık sonrası beden imajı ile ilgili daha çok sorun yaşadığı, (16)(17)(18)(19) özellikle yüzdeki yanıkların depresyon için tetikleyici olduğu, yanık yüzdesi ve yanan vücut bölgesinin psikiyatrik semptomlara yol açtığı öngörülmektedir (16)(17)(18)(19)(20). Hastanede kaldığı süre içinde 8 kez greftleme yapılan olgunun durumu kabullenmesi zaman aldı.…”