Violent burns are associated with poorer life satisfaction and unemployment after injury.

Abstract

Assaults can result in violent burn injuries, leading to a profound impact on survivors. These burns can cause physical pain, psychological trauma, and challenges in employment. In this study, we aim to explore socioeconomic demographics and longitudinal psychosocial outcomes associated with violent burns. Adult participants admitted for acute burn injury between 1993 and 2023 within the Burn Model System (BMS) database were included in the study. Patients with self-inflicted burn injuries were excluded. Participant demographics were summarized using descriptive statistics and compared between the intentional and unintentional burn cohorts with Wilcoxon-Mann-Whitney and Chi-square tests. A logistic regression model was constructed to investigate longitudinal occurrences of anxiety, depression, and posttraumatic stress symptoms, posttraumatic growth, employment status, and satisfaction with life. A total of 4668 patients were included in the study, of whom 147 (3.15 %) sustained violent burns. The intentional burn cohort was more likely to be Black (p < 0.001), unemployed (p < 0.001), have lower income (p = 0.001), and less likely to have completed graduate education (p < 0.001) than the unintentional burn cohort. Participants with intentional burn injuries had larger burns (24.0 vs. 16.6 % total body surface area, p < 0.001). Post-burn anxiety, depression, post-traumatic growth, and post-traumatic stress were not significantly associated with burn intentionality. After controlling for burn total body surface area, patients with violent burns were more likely to experience unemployment (p < 0.001) and poorer satisfaction with life (p < 0.001) after injury. Violent, intentional burn injuries disproportionately impact historically marginalized and socioeconomically disadvantaged individuals. These injuries lead to poorer quality of life without an equivalent impact on psychological health across groups. Future research should focus on exploring dissatisfaction with life, barriers to employment, and the role of vocational counseling in addressing these challenges within this patient population.