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The main objectives of this study were to investigate whether patients with self-inflicted burns have larger burns, and a worse outcome, than patients with accidental burns. The secondary objective was to examine patient pre-injury characteristics to identify ways of preventing the burn occurring. A case-controlled study was performed: 36 deliberate self-burn patients were matched separately to two groups of accidental burn patients. The first group was used to compare burn severity. Patients were matched for age and sex; they were excluded if they had a psychiatric diagnosis, or a non-burn injury. The second group was used to compare outcome. The same matching and exclusion criteria were used as in the first group, with the addition of burn-size. Deliberate self-burn patients have significantly larger burns (p<0.01; median total body surface area (TBSA) 10% versus 1.5%) than accidental burn patients. They also stay in hospital longer, even when matched for burn-size (p<0.02; median stay 15 days versus 9 days). Self-inflicted burns occurred in supervised environments in 28% of cases. The number of deliberate self-burns could be reduced with simple interventions such as restricting smoking in hospitals and prisons, and also by identifying high-risk patients. The poor outcome from deliberate self-burns could be improved by well-coordinated multidisciplinary patient management with early psychiatric team involvement.

Original publication

DOI

10.1016/j.burns.2004.12.006

Type

Journal

Burns : journal of the International Society for Burn Injuries

Publication Date

06/2005

Volume

31

Pages

471 - 475

Addresses

Chelsea and Westminster Hospital, London, England. benhorner@doctors.org.uk

Keywords

Humans, Burns, Length of Stay, Trauma Severity Indices, Risk Factors, Case-Control Studies, Self-Injurious Behavior, Suicide, Attempted, Smoking, Mental Disorders, Accidents, Adult, Middle Aged, Prisoners, London, Female, Male