Citation

Thombs BD, Bresnick MG. Crit. Care Med. 2008; 36(1): 118-125.

Affiliation

Department of Psychiatry, Sir Mortimer B. Davis-Jewish General Hospital and McGill University, Montreal, Quebec (BDT); and the Department of Psychiatry and Behavioral Sciences and the Johns Hopkins Burn Center.

Copyright

(Copyright © 2008, Society of Critical Care Medicine, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/01.CCM.0000293122.43433.72

PMID

18090371

Abstract

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. DESIGN:: Retrospective, cohort study. SETTING:: A total of 70 burn centers from the United States that contributed data to the American Burn Association National Burn Repository. PATIENTS:: A total of 30,382 adult patients (593 with self-inflicted injuries) who were admitted with a thermal injury from 1995 through 2005. INTERVENTIONS:: None. MEASUREMENTS AND MAIN 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 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.

Language: en