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Long-term mental health outcomes after unintentional burns sustained during childhood: a retrospective cohort study
Janine M Duke1, Sean M Randall2, Thirthar P Vetrichevvel3
11Burn Injury Research Unit, Faculty Health and Medical Sciences, The University of Western Australia, M318 35 Stirling Highway, Crawley, Perth, Western Australia 6009 Australia.
Insights
Children with burns face significantly higher long-term mental health admission rates. This highlights the need for extended mental health support following paediatric burn injuries to address potential psychiatric issues.
Area of Science:
- Pediatric Burn Care
- Mental Health Research
- Public Health
Background:
- Burns are severe injuries with lasting physical and psychological impacts.
- Limited data exists on the long-term mental health outcomes for children who have experienced burns.
- This study investigates mental health admissions following paediatric burns.
Purpose of the Study:
- To assess the long-term mental health (MH) admissions in children after sustaining unintentional burns.
- To compare the rate of mental health admissions between children with burns and an uninjured cohort.
Main Methods:
- A retrospective cohort study involving 11,967 children hospitalized for a first burn (1980-2012) in Western Australia.
- A frequency-matched comparison cohort of 46,548 uninjured children was included.
- Linked hospital, mental health, and mortality data were analyzed using multivariable negative binomial regression.
Main Results:
- The burn cohort exhibited a 2.55 times higher adjusted rate of post-burn mental health admissions compared to the uninjured cohort.
- Mental health admission rates were elevated across all age groups, particularly for those aged 10-14 years (4.90 times higher).
- Higher admission rates were observed for mood and anxiety disorders, psychotic disorders, and substance abuse issues in the burn cohort.
Conclusions:
- Paediatric burn survivors require ongoing mental health support post-discharge.
- Proactive mental health interventions can potentially mitigate psychiatric morbidity and related academic, social, and psychological challenges.
- This research underscores the critical need for comprehensive, long-term mental health care for childhood burn survivors.
Background:
Burns are a devastating injury that can cause physical and psychological issues. Limited data exist on long-term mental health (MH) after unintentional burns sustained during childhood. This study assessed long-term MH admissions after paediatric burns.
Methods:
This retrospective cohort study included all children (< 18 years) hospitalised for a first burn (n = 11,967) in Western Australia, 1980-2012, and a frequency matched uninjured comparison cohort (n = 46,548). Linked hospital, MH and death data were examined. Multivariable negative binomial regression modelling was used to generate incidence rate ratios (IRR) and 95% confidence intervals (CI).
Results:
The burn cohort had a significantly higher adjusted rate of post-burn MH admissions compared to the uninjured cohort (IRR, 95% CI: 2.55, 2.07-3.15). Post-burn MH admission rates were twice as high for those younger than 5 years at index burn (IRR, 95% CI 2.06, 1.54-2.74), three times higher for those 5-9 years and 15-18 years (IRR, 95% CI: 3.21, 1.92-5.37 and 3.37, 2.13-5.33, respectively) and almost five times higher for those aged 10-14 (IRR, 95% CI: 4.90, 3.10-7.76), when compared with respective ages of uninjured children. The burn cohort had higher admission rates for mood and anxiety disorders (IRR, 95% CI: 2.79, 2.20-3.53), psychotic disorders (IRR, 95% CI: 2.82, 1.97-4.03) and mental and behavioural conditions relating to drug and alcohol abuse (IRR, 95% CI: 4.25, 3.39-5.32).
Conclusions:
Ongoing MH support is indicated for paediatric burn patients for a prolonged period after discharge to potentially prevent psychiatric morbidity and associated academic, social and psychological issues.
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