Intentional injuries and patient survival of burns: A 10-year retrospective cohort in southern Brazil

Duarte, Daniele Walter; Neumann, Cristina Rolim; Weber, Elisabete Seganfredo

doi:10.1016/j.burns.2014.07.019

Cited by 9 publications

(4 citation statements)

References 36 publications

(68 reference statements)

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“…Similarly, high reports of MH prevalence (55%, 65%) have been reported among self-harm burn patients in studies from the UK [ 10 , 35 ]. The prevalence of psychiatric disease among assault patients was also similar to that found in other studies in the UK (12.2%) [ 35 ] and in Brazil (50% in self-inflicted, 10% in assault, 3.4% in unintentional) [ 40 ]. High incidence of MH issues (73%) has been reported among self-injury burn patients in comparison with all (both intentional and unintentional burns (4%)) in a study from New South Wales, Australia [ 13 ].…”

Section: Discussionsupporting

confidence: 86%

“…However, the occurrence of each of these types of mental illness was highest among the self-harm group followed by those with assault and unintentional burns, with the trend being statistically significant. This is a general trend reported in numerous studies [ 13 , 40 , 45 ]. Davidson et al found the incidence of depression in self-harm patients (31%) to be similar to our results (35.8%); however, psychotic illness (19%) [ 10 ] was marginally higher than that in this self-harm burns cohort (13.9%).…”

Section: Discussionsupporting

confidence: 81%

“…This increased severity of burns is presumed to be an important cause of longer hospital stays (index admission) and mortality observed among self-harm burns [ 40 ]. In this study, LOS was markedly different between self-harm burns (median 15 days), assault burns (4 days) and unintentional burns (4 days), similar to the patterns reported in another Australian study (average LOS self-inflicted burns of 52 days vs 12 days for the burn unit average) [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Pre-existing alcohol/drug abuse was significantly higher among self-burns (16.1%) and assault burns (14.6%) patients in comparison with the unintentional burns (2%). Most other studies from the UK and USA have reported higher alcohol/drug use (25 to 36%) [ 14 , 15 , 35 , 40 ], while lower prevalence has also been reported [ 10 ]. A prior history of self-harm admission was significantly higher (35%) in our self-harm burn cohort in comparison to the assault (6.3%) and unintentional burn (1.7%) cohorts, results consistent with other studies [ 15 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

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A population-based comparison study of the mental health of patients with intentional and unintentional burns

et al. 2018

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BackgroundA number of studies report high prevalence of mental health conditions among burn patients. However there is a need to understand differences in the temporal relationship between mental health conditions and intentional and unintentional burns to hasten psychological prevention and intervention. This study aims to compare the socio-demographic profile, burn characteristics and pre- and post-burn psychiatric morbidity of burn patients by intent-of-injury.MethodsDe-identified linked hospital, death and mental health (MH) case registry data of burn patients hospitalised in Western Australia between 1 January 1980 and 30 June 2012 were analysed. Crude (observed) post-burn rates of mental health admissions were generated by burn intent-of-injury. Descriptive statistics were performed to compare the characteristics of the burn patients.ResultsA total of 30,997 individuals were hospitalised for a first burn; 360 (1.2%) had self-harm burns and 206 (0.7%) assault burns. Over the study period, admission rates for assault burns increased by 4.8% per year (95% confidence interval (CI) 3.1–6.5%) and self-harm burns increased 6.9% per year (95% CI 4.8–9.1%). Self-harm and assault burns occurred mainly among those aged 15 to 44 years (median age, interquartile range (IQR): self-harm 30 years, 22–40; assault 31 years, 23–38). Those with self-harm burns had a longer index hospital stay (median (IQR): self-harm 15 days (5–35) vs 4 days (1–11) assault vs 4 days (1–10) unintentional) and higher in-hospital mortality (7.2% self-harm vs 1.9% assault burns vs 0.8% unintentional). More than half (55.0%) of self-harm burns had a prior hospitalisation (5-year lookback) for a MH condition vs 10.7% of assault burns and 2.8% of unintentional burns. Crude post-burn rates of MH admissions per 100 person-years (PY) by intent-of-burn subgroups: self-harm 209 per 100 PY, assault burns 11 per 100 PY and unintentional burns 3 per 100 PY.ConclusionsIntentional burn patients experienced significantly higher pre- and post-burn mental health morbidity along with significant adverse outcome in comparison with unintentional burns. Early psychological assessment and intervention could help in improving the MH of these patients.

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