title: Suicide by burning: epidemiological and clinical profiles.
abstract: Self-immolation constitutes a rare form of suicide in developed countries, though it accounts for unique injury characteristics in the burn intensive care unit. The aim of this study was to present the epidemiological and clinical features of patients burned during a suicidal attempt seen in a North Rhine-Westphalia burn intensive care unit (BICU). To address this aim, we undertook a 21-year retrospective study involving patients with thermal injuries admitted to the largest burn unit in Germany. A total of 125 suicide-related burn victims were identified in the study period (9.4%). Comparing the self-immolation group with the rest burn patient cohort, suicide victims were more likely to be single and to act under the influence of alcohol. The suicidal group had a larger extent of burns, higher incidence of inhalation injury, required more surgical procedures, catecholamines, blood transfusions, and a longer BICU stay. Their clinical course was complicated by prolonged intubation period, higher rate of multiple drug-resistant bacteria acquisition and sepsis, leading to a higher mortality rate. Although the proportion of self-immolation victims among all burned patients is not high, the markedly higher severity of their burns and their poorer quality of outcomes makes them an important clinical subgroup for further study.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Merheim-Hospital University of Witten-Herdecke, Cologne, Germany. panos_theodorou@yahoo.de
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Theodorou
authors.forename: Vu T Q
authors.initials: VT
authors.lastname: Phan
authors.forename: Christian
authors.initials: C
authors.lastname: Weinand
authors.forename: Marc
authors.initials: M
authors.lastname: Maegele
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Maurer
authors.forename: Walter
authors.initials: W
authors.lastname: Perbix
authors.forename: Sebastian
authors.initials: S
authors.lastname: Leitsch
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
authors.forename: Gerald
authors.initials: G
authors.lastname: Spilker
mesh_terms: D000328:Adult; D002053:Burn Units / Q000706:statistics & numerical data; D002056:Burns / Q000401:mortality* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015995:Prevalence; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000401:mortality* / Q000628:therapy*; D015208:Smoke Inhalation Injury / Q000401:mortality*; D013405:Suicide / Q000145:classification; D055815:Young Adult