Burns With Intent: A Retrospective Analysis of Self-Inflicted Burn Injuries

Self-inflicted burns (SIB) comprise a significant and yet minimally researched area within burn injuries and are often associated with high morbidity and mortality. We analyzed a total of 49 SIB and 28 assault burns (AB) out of 1,293 total burn patients. In our region, adult SIB, AB, and nonintentional burns were primarily white middle-aged men, with minority ethnic groups afflicted at a higher rate in SIB and assault groups. The difference between the nonintentional and SIB group was significant for total body surface area (TBSA), second-degree TBSA, third-degree TBSA inhalation injury, as well as history of mental illness, drug abuse, self-harm, mental hospitalization, self-harm hospitalization, abuse, burn hospitalization, and burn symmetry on admission. An analysis of psychiatric ailments revealed that patients with certain medical conditions had significantly higher odds of having committed a SIB injury: 9 times in depression, 10 times in acute schizophrenia, and 25 times in borderline personality. Most SIB were suicide attempts (67%), with the most common known etiology being gasoline (35%), and the most common prior life event was a dispute with another individual (27%). While SIB constitutes a small number of patients in the hospital, the proportional mortality is greater due to the frequency of SIB patients with larger burn injuries. As burn care continues to improve, the steps to decrease morbidity and mortality of burn care may need to shift to preventative measures and collaboration with municipal districts to identify and diffuse high-risk patients prior to an SIB occurring.