In-hospital Mortality Following Suicidal Burns: A Propensity Score-Matched Analysis

Area of Science:

• Medicine
• Surgery
• Trauma Care

Background:

• Burn injuries from suicide attempts present unique challenges.
• Comparing outcomes of intentional vs. accidental burns is crucial for treatment protocols.

Purpose of the Study:

• To compare clinical and demographic parameters of burn patients following suicide attempts versus accidental burns.
• To evaluate the impact of burn severity and patient characteristics on outcomes.
• To determine if life-sustaining treatment should be withheld in suicide attempt burn cases.

Main Methods:

• Retrospective single-center study of intensive care burn unit admissions over 14 years.
• Analysis of clinical and demographic data.
• Propensity score matching to control for age, sex, total body surface area (TBSA), full-thickness burns, and inhalation injury.

Main Results:

• 45 suicide attempt burn patients and 1266 accidental burn patients were admitted.
• Suicidal burn patients were younger with higher burn severity (TBSA, full-thickness, inhalation injury), longer hospital length of stay (LOS), and ventilation durations.
• In-hospital mortality was significantly higher in the suicide attempt group before matching.
• After propensity score matching (42 case pairs), no significant differences in in-hospital mortality, LOS, ventilation duration, or surgical interventions were detected.

Conclusions:

• Attempted suicide by burning is associated with worse outcomes and higher mortality rates initially.
• Propensity score matching revealed comparable outcomes between suicide attempt and accidental burn patients.
• Life-sustaining treatment should not be withheld from burn patients who attempted suicide due to similar survival probabilities post-matching.