How self-inflicted injury and gender impacted the outcome following a severe burn.

Abstract

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. 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. 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. 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 24h 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. 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.