Intentional burns in Nepal: a comparative study
| Autor: | Hilary J. Wallace, Bir Bahadur Lama, Buland Thapa, Peeyush Dahal, Nara Devi Bariya, Narayan Prasad Sharma, Wendy Marston, Janine M. Duke |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Urban Population Body Surface Area Poison control Suicide Attempted Critical Care and Intensive Care Medicine Occupational safety and health Cohort Studies Risk Factors Epidemiology Child Aged 80 and over Trauma Severity Indices Mortality rate General Medicine Middle Aged Suicide Emergency Medicine Income Female Medical emergency Public Health Burns Psychosocial Adult Employment medicine.medical_specialty Adolescent Substance-Related Disorders Violence Fires Kerosene Adjustment Disorders Young Adult Age Distribution Nepal Injury prevention medicine Humans Interpersonal Relations Risk factor Sex Distribution Aged Retrospective Studies Marital Status business.industry medicine.disease Social Class Emergency medicine Surgery business Total body surface area Self-Injurious Behavior |
| Zdroj: | Burns : journal of the International Society for Burn Injuries. 41(6) |
| ISSN: | 1879-1409 |
| Popis: | Aims Intentional burns injuries are associated with high mortality rates, and for survivors, high levels of physical and psychological morbidity. This study provides a comprehensive assessment of intentional burn admissions to the adult Burns Unit at Bir Hospital, Kathmandu, Nepal, during the period 2002–2013. Methods A secondary data analysis of de-identified data of patients hospitalized at Bir Hospital, Kathmandu, with a burn during the period of 1 January 2002 to 31 August 2013. Socio-demographic, injury and psychosocial factors of patients with intentional and unintentional burns are described and compared. Chi-square tests, Fisher's exact test and Wilcoxon rank sum tests were used to determine statistical significance. Results There were a total of 1148 burn admissions of which 329 (29%) were for intentional burn, 293 (26%) were self-inflicted and 36 (3%) were due to assault. Mortality rates for intentional burns were approximately three times those for unintentional burns (60 vs. 22%). When compared to unintentional burns, patients with intentional burns were more likely to be female (79 vs. 48%), married (84 vs. 67%), younger (25 vs. 30 years), have more extensive burns (total body surface area, %: 55 vs. 25) and higher mortality (60 vs. 22%). Intentional burns were more likely to occur at home (95 vs. 67%), be caused by fire (96 vs. 77%), and kerosene was the most common accelerant (91 vs. 31%). A primary psychosocial risk factor was identified in the majority of intentional burn cases, with 60% experiencing adjustment problems/interpersonal conflict and 32% with evidence of a pre-existing psychological condition. A record of alcohol/substance abuse related to the patient or other was associated with a greater proportion of intentional burns when compared with unintentional burns (17 vs. 4%). Conclusions The majority of intentional burn patients were female. Almost all intentional burns occurred in the home and were caused by fire, with kerosene the most common accelerant used. Underlying psychosocial risk factors were identified in most cases. Intentional burns resulted in severe burns with high mortality. Intentional burns are not only a serious medical issue; they represent significant public health and gender issues in Nepal. |
| Databáze: | OpenAIRE |
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