title: Intentional injuries and patient survival of burns: a 10-year retrospective cohort in southern Brazil.
abstract: BACKGROUND
  Patients burned intentionally experience extensive injuries with high rates of morbidity and mortality. Nonetheless, there is no consensus if these patients have worse outcomes than unintentional burns considering injury severity and other preexistent comorbidities.
  
  
  METHODS
  We conducted a ten-year retrospective review on all patients treated at the Burn Unit of Hospital de Pronto Socorro, Porto Alegre, Brazil, between 2003 and 2012. The aim was to compare survival of self-inflicted burns and burns from assaults with unintentional injuries using a Multivariable Cox Regression Analysis.
  
  
  RESULTS
  1734 patients were included in the study, 87.7% non-intentional, 6.6% self-inflicted and 5.8% from aggression. Intentional injuries resulted in more severe injuries and were associated with psychiatric disorders and drug abuse. After controlling for injury severity, previous clinical comorbidities and previous psychiatric disorders, only self-inflicted burns correlated significantly with a higher risk of death (HR=1.59, CI 95% 1.05-2.41, p=0.03).
  
  
  CONCLUSIONS
  Self-inflicted injuries were independently associated with a higher risk of death. Burns from aggression were not associated with higher mortality in this model. Prevention of these injuries must be priority and treating the main associated factors such as drug abuse and psychiatric disorders may lower its occurrence.
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Brazil. Electronic address: nicaduwal@ig.com.br.
authors.forename: Daniele Walter
authors.initials: DW
authors.lastname: Duarte
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Primary Care Service, Hospital de Clínicas de Porto Alegre, Brazil. Electronic address: cristinaneumann@via-rs.net.
authors.forename: Cristina Rolim
authors.initials: CR
authors.lastname: Neumann
authors.affiliation: Department of Plastic Surgery, Hospital Ernesto Dornelles, Porto Alegre, Brazil; Department of Plastic Surgery, Hospital de Pronto Socorro (HPS), Porto Alegre, Brazil. Electronic address: elisabete.sw@gmail.com.
authors.forename: Elisabete Seganfredo
authors.initials: ES
authors.lastname: Weber
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002053:Burn Units / Q000706:statistics & numerical data; D002056:Burns / Q000209:etiology / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000401:mortality*; D017678:Sex Distribution; D017741:Survivors / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Aggression; Burns; Self-inflicted injuries; Suicide; Survival