Lisbon Burn Centre experience with intentional burn injuries

Area of Science:

• Trauma Surgery
• Psychiatry
• Public Health

Background:

• Burn injuries result from various forms of aggression, with distinct epidemiological and clinical characteristics.
• Intentional burns present unique challenges in burn care units, necessitating specific investigation.

Purpose of the Study:

• To compare risk factors, psychiatric comorbidities, injury severity, and mortality between accidental and intentional burn patients.
• To identify specific differences in outcomes for self-inflicted versus hetero-aggressive burns.

Main Methods:

• Retrospective analysis of routinely collected data from a Central Hospital Burn Unit.
• Inclusion of adult patients admitted over a six-year period (January 1, 2010, to December 31, 2015).

Main Results:

• Intentional burn patients (5% of admissions) were younger, had larger body surface area burns (35% vs. 14%), higher inhalation burn incidence (50% vs. 22.8%), and increased mortality (18.2% vs. 6.1%) compared to accidental burns.
• Self-inflicted burns had a worse prognosis (25% in-hospital mortality) than hetero-aggressions (10% mortality).
• Psychiatric comorbidities, particularly mood disorders, were significantly more prevalent in intentional burn patients (59% vs. 6.6%).

Conclusions:

• Intentional burn patients exhibit a worse clinical condition and prognosis than those with accidental burns.
• A multidisciplinary preventive approach is crucial for reducing the incidence and severity of intentional burns by addressing their violent nature and identifying at-risk individuals.