Mortality risk and length of stay associated with self-inflicted burn injury: evidence from a national sample of 30,382 adult patients.
OBJECTIVE
Existing studies report contradictory findings regarding characteristics and outcomes of patients admitted with self-inflicted burn injuries. The objective of this study was to report demographic and medical characteristics of patients admitted to burn centers with self-inflicted burn injuries and to assess mortality risk and length of stay compared with patients whose injuries were not self-inflicted.


METHODS
Retrospective, cohort study.


METHODS
A total of 70 burn centers from the United States that contributed data to the American Burn Association National Burn Repository.


METHODS
A total of 30,382 adult patients (593 with self-inflicted injuries) who were admitted with a thermal injury from 1995 through 2005.


METHODS
None.


RESULTS
Demographics, comorbidities, burn injury severity variables (total body surface area burned [TBSA], TBSA burned third degree, inhalation injury), hospital mortality, intensive care length of stay, and total hospital length of stay were ascertained. Patients with self-inflicted injuries had larger TBSA burned (32.0% vs. 12.8%, p < .01) and larger third-degree TBSA burned (20.6% vs. 4.9%, p < .01) and were more likely to incur an inhalation injury (37.3% vs. 12.8%, p < .01). Before matching, patients with self-inflicted injuries were at greater risk of mortality (23.6% vs. 6.8%, p < .01) and required longer intensive care (median of 4 days vs. 0 days, p < .01) and total hospital stays (median of 23 days vs. 8 days, p < .01). After propensity score matching on demographic, medical, and burn injury variables, they were not more likely to die of their injuries (23.6% vs. 23.1%, p = .84), did not require longer intensive care stays (4 days vs. 3 days, p = .75), and did not require longer total hospital stays (23 days vs. 18 days, p = .50).


CONCLUSIONS
Compared with patients with similar demographic, health, and injury characteristics whose injuries are not self-inflicted, patients with self-inflicted burn injuries are not at greater risk of mortality and do not require longer durations of intensive care or total hospitalization.
Thombs
Brett D
BD
Department of Psychiatry, Sir Mortimer B. Davis-Jewish General Hospital and McGill University, Montreal, Quebec. brett.thombs@mcgill.ca
Bresnick
Melissa G
MG
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000145:classification / Q000401:mortality* / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000145:classification / Q000401:mortality* / Q000628:therapy*; D017678:Sex Distribution; D015208:Smoke Inhalation Injury / Q000401:mortality; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology