Case-controlled study of patients with self-inflicted burns.
The main objectives of this study were to investigate whether patients with self-inflicted burns have larger burns, and a worse outcome, than patients with accidental burns. The secondary objective was to examine patient pre-injury characteristics to identify ways of preventing the burn occurring. A case-controlled study was performed: 36 deliberate self-burn patients were matched separately to two groups of accidental burn patients. The first group was used to compare burn severity. Patients were matched for age and sex; they were excluded if they had a psychiatric diagnosis, or a non-burn injury. The second group was used to compare outcome. The same matching and exclusion criteria were used as in the first group, with the addition of burn-size. Deliberate self-burn patients have significantly larger burns (p<0.01; median total body surface area (TBSA) 10% versus 1.5%) than accidental burn patients. They also stay in hospital longer, even when matched for burn-size (p<0.02; median stay 15 days versus 9 days). Self-inflicted burns occurred in supervised environments in 28% of cases. The number of deliberate self-burns could be reduced with simple interventions such as restricting smoking in hospitals and prisons, and also by identifying high-risk patients. The poor outcome from deliberate self-burns could be improved by well-coordinated multidisciplinary patient management with early psychiatric team involvement.
Horner
B M
BM
Chelsea and Westminster Hospital, London, England. benhorner@doctors.org.uk
Ahmadi
H
H
Mulholland
R
R
Myers
S R
SR
Catalan
J
J
D000059:Accidents; D000328:Adult; D002056:Burns / Q000473:pathology / Q000517:prevention & control / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008131:London; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D011329:Prisoners; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000473:pathology / Q000517:prevention & control / Q000523:psychology*; D012907:Smoking; D013406:Suicide, Attempted; D015599:Trauma Severity Indices