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A population-based comparison study of the mental health of patients with intentional and unintentional burns

摘要Background:A number of studies report high prevalence of mental health conditions among burn patients. However there is a need to understand differences in the temporal relationship between mental health conditions and intentional and unintentional burns to hasten psychological prevention and intervention. This study aims to compare the socio-demographic profile, burn characteristics and pre-and post-burn psychiatric morbidity of burn patients by intent-of-injury. Methods:De-identified linked hospital, death and mental health (MH) case registry data of burn patients hospitalised in Western Australia between 1 January 1980 and 30 June 2012 were analysed. Crude (observed) post-burn rates of mental health admissions were generated by burn intent-of-injury. Descriptive statistics were performed to compare the characteristics of the burn patients. Results:A total of 30,997 individuals were hospitalised for a first burn;360 (1.2%) had self-harm burns and 206 (0.7%) assault burns. Over the study period, admission rates for assault burns increased by 4.8%per year (95%confidence interval (CI) 3.1–6.5%) and self-harm burns increased 6.9%per year (95%CI 4.8–9.1%). Self-harm and assault burns occurred mainly among those aged 15 to 44 years (median age, interquartile range (IQR):self-harm 30 years, 22–40;assault 31 years, 23–38). Those with self-harm burns had a longer index hospital stay (median (IQR):self-harm 15 days (5–35) vs 4 days (1–11) assault vs 4 days (1–10) unintentional) and higher in-hospital mortality (7.2%self-harm vs 1.9%assault burns vs 0.8%unintentional). More than half (55.0%) of self-harm burns had a prior hospitalisation (5-year lookback) for a MH condition vs 10.7%of assault burns and 2.8%of unintentional burns. Crude post-burn rates of MH admissions per 100 person-years (PY) by intent-of-burn subgroups:self-harm 209 per 100 PY, assault burns 11 per 100 PY and unintentional burns 3 per 100 PY. Conclusions:Intentional burn patients experienced significantly higher pre-and post-burn mental health morbidity along with significant adverse outcome in comparison with unintentional burns. Early psychological assessment and intervention could help in improving the MH of these patients.

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作者单位 Burn Injury Research Unit, Faculty of Health and Medical Sciences, The University of Western Australia, M31835 Stirling Highway, Crawley, Perth,Western Australia 6009, Australia;Curtin Medical School, Curtin University,Perth, Australia [1] Centre for Data Linkage, Curtin University, Perth, WesternAustralia, Australia [2] Burn Injury Research Unit, Faculty of Health and Medical Sciences, The University of Western Australia, M31835 Stirling Highway, Crawley, Perth,Western Australia 6009, Australia;Burns Service of Western Australia, Fiona Stanley Hospital and Princess Margaret Hospital, Perth, Western Australia, Australia [3] Burn Injury Research Unit, Faculty of Health and Medical Sciences, The University of Western Australia, M31835 Stirling Highway, Crawley, Perth,Western Australia 6009, Australia [4]
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发布时间 2019-02-22(万方平台首次上网日期,不代表论文的发表时间)
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