Malic C C, Karoo R O S, Austin O, Phipps A
Pinderfields General Hospital, Wakefield, UK.
Burns. 2007 Feb;33(1):92-7. doi: 10.1016/j.burns.2006.04.008. Epub 2006 Oct 30.
In the United Kingdom, the incidence of assault by burning and of self inflicted burns increased significantly over the last decade. This has major implications both for service providers and society as a whole. Our aim was to investigate the differences in patients' characteristics, management and outcome following a burn sustained by either an assault or self immolation.
Acute admissions to a tertiary Burn Centre were retrospectively reviewed over an 11 year period (1994-2005). Demographic data and information regarding the circumstances surrounding the incident, burn severity, treatment and outcomes of the patients were collected.
Over an 11 year period, 1745 patients were admitted to the tertiary Burn Centre. Of this total, 41 patients (mean age 29 years+/-16) sustained burns following an assault, a further 86 patients (mean age of 37 years+/-12) had self inflicted burn injuries; males were preponderant in both groups. In this series, a history of alcohol or substance abuse was present in 25% of both cohorts, 63% of the patients with self inflicted injuries having a previously diagnosed psychiatric disorder. Petrol, accelerants and other flammable liquids were the main agents chosen to inflict injury in both the assault and self inflicted groups. The burn depth and surface area distribution was greater in the self inflicted group compared to those assaulted (29% versus 21%). A difference was also noted in the pattern of distribution of burns between the two groups, as well as between genders although this difference was not significant. Two-thirds (67.4%) of the self immolated patients and 56% of the assaulted group required surgery. The length of hospital stay was similar for both groups, averaging 20 days. The crude mortality for the self inflicted group was 29%, whereas in the assaulted patients, the overall mortality was 4.9%.
Although the incidence of burns caused either by assault or attempted suicide is low, the affected patients require a multidisciplinary approach. Their management requires significant medical, psychological occupational and social support. Increased awareness and education of those vulnerable individuals maybe of benefit to help prevent self inflicted injuries by burning.
在英国，过去十年间，烧伤袭击及自伤性烧伤的发生率显著上升。这对服务提供者乃至整个社会都产生了重大影响。我们的目的是调查遭受袭击或自焚烧伤患者在特征、治疗及预后方面的差异。
对一家三级烧伤中心11年期间（1994 - 2005年）的急性入院病例进行回顾性研究。收集患者的人口统计学数据以及有关事件发生情况、烧伤严重程度、治疗及预后的信息。
在11年期间，1745名患者入住该三级烧伤中心。其中，41名患者（平均年龄29岁±16岁）因袭击而烧伤，另有86名患者（平均年龄37岁±12岁）为自伤性烧伤；两组中男性均占多数。在该系列研究中，两组各有25%的患者有酗酒或药物滥用史，63%的自伤患者此前被诊断患有精神疾病。汽油、助燃剂及其他易燃液体是袭击组和自伤组中造成伤害的主要介质。与袭击组相比，自伤组的烧伤深度和表面积分布更大（分别为29%和21%）。两组之间以及不同性别之间的烧伤分布模式也存在差异，尽管这种差异并不显著。三分之二（67.4%）的自焚患者和56%的袭击组患者需要手术治疗。两组的住院时间相似，平均为20天。自伤组的粗死亡率为29%，而袭击组患者的总体死亡率为4.9%。
尽管烧伤袭击或企图自杀导致的烧伤发生率较低，但受影响的患者需要多学科方法。对他们的治疗需要大量的医疗、心理、职业及社会支持。提高对这些易受伤害个体的认识和教育可能有助于预防自伤性烧伤。
