Cornet P A, Niemeijer A S, Figaroa G D, van Daalen M A, Broersma T W, van Baar M E, Beerthuizen G I J M, Nieuwenhuis M K
Department of Psychiatry, Martini Hospital, Burn Centre, P.O. Box 30.033, 9700 RM Groningen, The Netherlands; Burn Centre Martini Hospital, P.O. Box 30.033, 9700 RM Groningen, The Netherlands.
Association of Dutch Burn Centres, Martini Hospital, Burn Centre, P.O. Box 30.033, 9700 RM Groningen, The Netherlands; Van Swieten Research Institute, Martini Hospital, P.O. Box 30.033, 9700 RM Groningen, The Netherlands.
Burns. 2017 Jun;43(4):789-795. doi: 10.1016/j.burns.2016.11.005. Epub 2017 Jan 5.
Patients with self-inflicted burns (SIB) are thought to have a longer length of stay compared to patients with accidental burns. However, other predictors for a longer length of stay are often not taken into account, e.g. percentage of the body surface area burned, age or comorbidities. Therefore, we wanted to study the outcome of patients with SIB at our burn center.
A retrospective, observational study was conducted. All adult patients with acute burns admitted to the burn center of the Martini Hospital Groningen, between January 1, 2009 and December 31, 2013 were included. Data on characteristics of the patient, injury, and outcome (LOS, mortality, discharge destination) were collected. In patients with SIB, suicide attempts (SA) were distinguished from self-harm without the intention to die (non-suicidal self-injury, NSSI). To evaluate differences in outcome, each patient with SIB was matched on variables and total score of the Abbreviated Burn Severity Index (ABSI) to a patient with accidental burns (AB).
In total 29 admissions (21 SA and 8 NSSI) were due to SIB and 528 due to accidents. Overall, when compared to AB, there were significant differences with respect to mortality and LOS for SA and/or NSSI. Mortality was higher in the SA group, while the LOS was higher in both the SA and NSSI groups compared to the AB group. However, after matching on ABSI, no statistical significant differences between the SA and SA-match or the NSSI and NSSI-match group were found.
With the right and timely treatment, differences in mortality rate or length of stay in hospital could all be explained by the severity of the burn and the intention of the patient.
与意外烧伤患者相比，自伤性烧伤（SIB）患者的住院时间被认为更长。然而，其他导致住院时间延长的预测因素常常未被考虑在内，例如烧伤的体表面积百分比、年龄或合并症。因此，我们希望研究我院烧伤中心自伤性烧伤患者的治疗结果。
开展了一项回顾性观察研究。纳入了2009年1月1日至2013年12月31日期间入住格罗宁根马提尼医院烧伤中心的所有成年急性烧伤患者。收集了患者特征、损伤情况及治疗结果（住院时间、死亡率、出院去向）的数据。在自伤性烧伤患者中，区分了自杀未遂（SA）和无自杀意图的自我伤害（非自杀性自我伤害，NSSI）。为评估治疗结果的差异，将每名自伤性烧伤患者按照简明烧伤严重程度指数（ABSI）的变量和总分与一名意外烧伤患者（AB）进行匹配。
共有29例入院病例（21例自杀未遂和8例非自杀性自我伤害）是由自伤性烧伤导致的，528例是由意外导致的。总体而言，与意外烧伤患者相比，自杀未遂和/或非自杀性自我伤害患者在死亡率和住院时间方面存在显著差异。自杀未遂组的死亡率更高，而与意外烧伤组相比，自杀未遂组和非自杀性自我伤害组的住院时间均更长。然而，在按照简明烧伤严重程度指数进行匹配后，自杀未遂组与匹配组之间以及非自杀性自我伤害组与匹配组之间均未发现统计学上的显著差异。
通过正确及时的治疗，死亡率或住院时间的差异均可由烧伤严重程度和患者意图来解释。
