Suicide by Burning

Theodorou, Panagiotis; Phan, Vu Thi; Weinand, Christian; Maegele, Marc; Maurer, Christoph A.; Perbix, Walter; Leitsch, Sebastian; Lefering, Rolf; Spilker, G.

doi:10.1097/sap.0b013e3182071f83

Cited by 20 publications

(2 citation statements)

References 46 publications

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“…However, this pattern was different in developed countries, where most of the time suicide by burning was equally distributed between males and females and sometimes it was higher among men (24-27). Also the proportion of suicidal cases was far less than Iran (28-30). But in most parts of Iran and other developing countries the main victims were women (31-33).…”

Section: Discussionmentioning

confidence: 88%

Predictive Factors of Mortality in Burn Patients

et al. 2014

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Background:Burn injuries impose a considerable burden on healthcare systems in Iran. It is among the top ten causes of mortality and a main cause of disability.Objectives:This study aimed to examine factors influencing mortality in burn patients admitted to the main educational tertiary referral hospital in Kermanshah.Patients and Methods:All patients admitted to the Imam Khomeini Hospital (from March 2011 to March 2012), due to thermal burn injuries were included in the study. We applied multiple logistic regressions to identify risk and protective factors of mortality. Also we calculated lethal area fifty percent (LA50), as an aggregate index for hospital quality.Results:During the study period, 540 burn patients were admitted. Male to female ratio was 1.12:1. Twenty three percent of the patients were less than 15 years-old. Median of age was 25 years (Inter Quartile Range, 16 - 37). Overall, probability of death was 25.8%. Lethal area fifty percent (LA50) was 50.82 (CI 95%: 47.76 - 54.48). In the final model, after adjustment of sex, age, total body surface area (TBSA), cause of burn and it’s severity, female gender (P < 0.05), age ≥ 60 years (in comparison with age less than 15 years, P < 0.05) and larger burn size (P < 0.0001) were identified as the main risk factors of death in these patients.Conclusions:Findings showed that the main risk factors of death were female gender, burn size and old age. Directing more attention to these vulnerable patients is required to reduce mortality and improve patient survival.

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Section: Discussionmentioning

confidence: 88%

Predictive Factors of Mortality in Burn Patients

et al. 2014

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“…There are uncertainties regarding the exact reason behind this trend. It has been thought that it can be due to the higher rate of self-immolation in female patients, which generally is associate with less favorable outcomes 27 , 28 . However, we speculate that the reason behind our discrepancy with the existing literature may be the difference in the overall incidence of burn injuries between the two genders.…”

Section: Discussionmentioning

confidence: 99%

Cohort analysis of 50% lethal area (LA50) and associating factors in burn patients based on quality improvements and health policies

Shahriarirad,

Shekouhi,

Nabavizadeh

et al. 2023

Sci Rep

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Burn injuries are among the common traumatic injuries, which can be accompanied with lifelong morbidity and mortality. The Lethal Area Fifty Percent (LA50) index is another reliable outcome measurement tool that assesses the standard of medical care at burn centers. It is widely used as a benchmark for assessing the quality of burn care and is considered the percentage at which 50% of burn patients are expected to die because of burn-related injuries. We aimed to determine and compare the LA50 in burn patients admitted to Shiraz Burn Referral Centers in 2018–2021 and 2011–2018 with regard to improving the quality of special care and infection control in the new hospital. We conducted a retrospective cohort analysis on patients admitted to Amir al-Momenin Burn Injury Hospital in Shiraz, Fars, Southern Iran. Data were retrospectively gathered from March 2011 to January 2022, and subsequently analyzed with standard statistical analysis, and also multivariate and probability analysis. A total of 7382 patients with acute burns injuries were identified. Among them, 4852 (65.7%) patients were men, and the median age was 27 years [Q1–Q3 7–40; range 1–98]. Most of the patients were in the pediatric and early adulthood age range, with 76.2% being younger than 40 years old. The median TBSA was 24% [IQR 14, 43], and the median duration of hospitalization was 11 [IQR 11] days. Most injuries were secondary to flame and fire (33.5%; n = 2472). The mortality rate in our study was 19.0% (n = 1403). We evaluated our patients based on two main time intervals: March 2011 till February 2018 (n = 3409; 46.2%), and March 2018 to January 2022 (n = 3973; 53.8%). Based on multivariate analysis, the second interval of our study was significantly correlated with a more female patients, higher age, lower TBSA, less burn injuries due to scald, contact, but more frequent fire and flame injuries, and also lower mortality rate. Factors correlated with higher mortality included male gender, older age, shorter hospitalization duration, higher TBSA, etiology of fire and flame, and accidental burn injuries. A Baux score of 76.5 had a sensitivity of 81.1%, specificity of 87.3%, accuracy of 86.1% in predicting mortality among our patients. The mortality probability for the study intervals were 20.67% (SD 33.0%) for 2011–2018, and 17.02% (SD 29.9%) for 2018–2022 (P < 0.001). The LA50 was 52.15 ± 2 for all patients. This ammount was 50 ± 2% in 2011–2018, and 54 ± 2 in 2018–2022 (P < 0.001). The mean LA50 values showed significant improvements following significant modifications in our critical care for burn victims, including augmented intensive care unit capacity, prompt relocation of inhalation burn cases to the intensive care unit, establishing a well-trained multidisciplinary team, and improved infection control. To improve outcomes for burn patients in developing countries, major changes should be made in the management of burn patients and LA50 is a reliable assessment tool for evaluating the how these changes affect patient’s outcomes.

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