Exploratory analysis of long-term physical and mental health morbidity and mortality: A comparison of individuals with self-inflicted versus non-self-inflicted burn injuries

Autor: Frederick J. Stoddard, Jennifer R. Gueler, Kimberly Roaten, Colleen M. Ryan, James A. Fauerbach, Kara McMullen, Shelley A. Wiechman, Radha K. Holavanahalli, Karen J. Kowalske
Rok vydání: 2019
Předmět:
Biopsychosocial model
Male
Burn injury
Databases
Factual
Poison control
Anxiety
Patient Health Questionnaire
Critical Care and Intensive Care Medicine
Occupational safety and health
030207 dermatology & venereal diseases
0302 clinical medicine
Medicine
Longitudinal Studies
Prospective Studies
Depression (differential diagnoses)
Aged
80 and over
Depression
General Medicine
Middle Aged
Hospitalization
Psychosocial Functioning
Emergency Medicine
Female
medicine.symptom
Burns
Adult
Employment
medicine.medical_specialty
Adolescent
Substance-Related Disorders
Suicidal Ideation
03 medical and health sciences
Young Adult
Age Distribution
Injury prevention
Humans
Mortality
Sex Distribution
Aged
Marital Status
business.industry
030208 emergency & critical care medicine
social sciences
Length of Stay
Mental health
Respiration
Artificial
United States
Emergency medicine
Surgery
business
Self-Injurious Behavior
Zdroj: Burns : journal of the International Society for Burn Injuries. 46(3)
ISSN: 1879-1409
Popis: Self-inflicted burn (SIB) injuries are relatively rare, but patients may experience complex biopsychosocial challenges. This study aimed to compare long-term physical and psychological outcomes for individuals with SIB and non-SIB injuries.Records of adult SIB (n = 125) and non-SIB (n = 3604) injuries were collected from U.S. burn centers within the Burn Model System between 1993 and 2018. Assessments were administered at discharge, 6 months, 24 months, 5 years, and 10 years.SIB patients were more often younger, unmarried, unemployed, male, struggling with pre-morbid psychiatric issues, and injured by fire/flame (all p 0.001). SIB injury predicted prolonged mechanical ventilation, hospitalization, and rehabilitation (all p 0.001). After injury, SIB patients had increased anxiety at 24 months (p = 0.0294), increased suicidal ideation at 5 years (p = 0.004), and clinically worse depression at 10 years (p = 0.0695). SIB patients had increased mortality across 24 months compared to non-SIB patients (OR = 4.706, p = 0.010).SIB injuries are associated with worse physical and psychological outcomes compared to non-SIB injuries including complicated hospitalizations and chronic problems with anxiety, depression, suicidality, and mortality, even when controlling for common indicators of severity such as burn size. This underscores the importance of multidisciplinary treatment, including mental healthcare, and long-term follow-up for SIB patients. Identified pre-morbid risk factors indicate the need for targeted injury prevention.
Databáze: OpenAIRE
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