Kaufman Marla S, Graham Christina C, Lezotte Dennis, Fauerbach James A, Gabriel Vincent, Engrav Loren H, Esselman Peter
Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, Washington 98104, USA.
J Burn Care Res. 2007 Jan-Feb;28(1):21-8; discussion 29. doi: 10.1097/BCR.0B013E31802C896F.
The purpose of this study was to identify specific premorbid factors and injury characteristics associated with intentional burn injuries and to compare outcomes for individuals injured by assault and those with unintentional injuries. Participants sustaining major burns from May 1994 to August 2005 and consenting to a multisite, prospective, longitudinal outcome study were included. Etiology of the injury was classified as intentional (i.e., assault) or unintentional. Subjects <18 years old or with self-inflicted burns were excluded. Statistical analysis was performed with t-tests, chi2 tests, and analysis of variance. Eighty patients sustained intentional burn injuries and 1982 subjects sustained nonintentional burn injuries. Compared to patients with nonintentional burns, those with burns related to assault were more likely to be female, black, and unemployed and to have higher rates of premorbid substance use. Between the groups, there were no significant differences in preinjury living situation, education level, history of psychiatric treatment, or hospital length of stay. The intentional-burn group had larger burns and a greater in-hospital mortality rate, and these patients were less likely to be discharged to home. They also demonstrated significantly greater levels of psychological distress during the acute hospitalization but not at follow-up. Understanding the unique characteristics and needs of patients with intentional burn injuries is important because these individuals are less likely to have a steady income and more likely to rely on community social services. Affordable and accessible community-based health services are necessary in order to improve their outcomes.
本研究的目的是确定与故意烧伤相关的特定病前因素和损伤特征，并比较受攻击伤害的个体与意外伤害个体的结局。纳入了1994年5月至2005年8月期间遭受严重烧伤并同意参与一项多中心、前瞻性、纵向结局研究的参与者。损伤的病因分为故意（即攻击）或非故意。排除年龄<18岁或有自残烧伤的受试者。采用t检验、卡方检验和方差分析进行统计分析。80例患者遭受故意烧伤，1982例受试者遭受非故意烧伤。与非故意烧伤患者相比，与攻击相关烧伤的患者更可能为女性、黑人且失业，病前物质使用发生率更高。两组之间，伤前生活状况、教育水平、精神治疗史或住院时间无显著差异。故意烧伤组的烧伤面积更大，院内死亡率更高，这些患者出院回家的可能性更小。他们在急性住院期间也表现出明显更高水平的心理困扰，但随访时没有。了解故意烧伤患者的独特特征和需求很重要，因为这些个体不太可能有稳定收入，更可能依赖社区社会服务。为了改善他们的结局，提供负担得起且可及的社区卫生服务是必要的。
