How self-inflicted injury and gender impacted the outcome following a severe burn. Issue 3 (May 2019)

• Record Type: Journal Article
• Authors: Dobson, Hannah; Lee, Stuart; Breadon, Carolyn; Cleland, Heather; Moncur, Donovan; Kulkarni, Jayashri
• Is Part Of: Burns. Volume 45:Issue 3(2019)
• Page Start: 621
• Page End: 626
• Publication Date: 2019-05
• Subjects: Burns -- Deliberate self-harm -- Self-injurious behaviour -- Suicidal ideation -- Outcome studies; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2018.10.021
• Languages: English
• ISSNs: 0305-4179

Abstract

Highlights: Past research has shown self-inflicted burn injuries are associated with a higher %total body surface area burn (TBSA) than accidental injuries. Patients in our sample with self-inflicted burn injuries were more likely to have a past psychiatric diagnosis. Patients in our sample with self-inflicted burn injuries were more likely to have public mental health service contact in the month pre-injury. We found that male patients with self-inflicted injury were far more likely to die than males with a non-self-inflicted injury. Abstract: Background: A high prevalence of self-inflicted burn injury is noted in severe burn injury. It remains unclear as to whether gender and past psychiatric history impact upon whether injury is self-inflicted and the outcomes. Aims: Review the psychiatric history of patients treated in a statewide burn service following severe burn injury and determine whether psychiatric history, extent of burn and mortality are impacted by gender and whether the injury was self-inflicted. Method: A data linkage study was performed with psychiatric history and mental health service contact data matched to patients' data collected via a previous retrospective file audit. Unadjusted and adjusted logistic regression modelling measured interactions between gender and self-inflicted burn status, and other study outcomes. Results: In total, 298 patients (47 with a self-inflicted burn) were admitted following a severe burn. Patients with self-inflicted burns were significantly more likely to have total body surface area burn of at least 50% (OR = 9.3; 95%CI: 4.7–18.5) and die within 24 h of admission (OR = 10.5; 95%CI:4.7–23.2). They were significantly more likely to have a past psychiatric diagnosis and public mental health service contact in the month pre-injury (OR = 18.9; 95%CI: 7.5–47.2). Male patients had significantly lower rates of a psychiatric diagnosis and recent mental health service contact. Males with self-inflicted injury are far more likely to die than males with a non-self-inflicted injury. Conclusions: Psychiatric clinicians should assertively screen the psychiatric history of patients with severe burn injury, and participate in the acute and longer-term management of persons admitted with a self-inflicted burn.