Citation

Mason SA, Nathens AB, Byrne JP, Ellis J, Fowler RA, González A, Karanicolas PJ, Moineddin R, Jeschke MG. J. Am. Coll. Surg. 2017; 225(4): 516-524.

Affiliation

Sunnybrook Research Institute, Toronto, Canada; Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Canada.

Copyright

(Copyright © 2017, American College of Surgeons, Publisher Elsevier Publishing)

DOI

10.1016/j.jamcollsurg.2017.06.004

PMID

28774550

Abstract

BACKGROUND: Mental health disorders are prevalent before and after burn injury. However, the impact of burn injury on risk of subsequent mental health disorders is unknown. STUDY DESIGN: We conducted a population-based, self-matched longitudinal cohort study using administrative data in Ontario, Canada between 2003 and 2011. All adults who survived to discharge following major burn injury were included, and all mental health-related emergency department visits were identified. Rate ratios for mental health visits in the three years after burn, compared to the three years prior, were estimated using negative binomial generalized estimating equations.

RESULTS: Among 1530 patients with major burn injury, mental health visits were common both before (141 per 1000 person years) and after (154 per 1000 person years) injury. Mental health visits were most common in the 12 weeks immediately preceding injury. No significant difference in the overall visit rate was observed after burn (RR 0.97, 95% CI 0.78-1.20), though among patients with <1 pre-injury visit, mental health visits tripled (RR 3.72, 95% CI 2.70-5.14). Self-harm emergencies increased two-fold (RR 1.95, 95% CI 1.15-3.33).

CONCLUSIONS: Mental health emergencies are prevalent amongst burn-injured patients. Although the overall rate of mental health visits is not increased after burn, the rate increases significantly among patients with one or fewer visits pre-injury. Self-harm risk increases significantly after burn injury, underscoring the need for screening and targeted interventions after discharge. An increased rate immediately prior to burn suggests an opportunity for injury prevention through mental healthcare.

Copyright © 2017. Published by Elsevier Inc.

Language: en