Duke Janine M, Randall Sean M, Vetrichevvel Thirthar P, McGarry Sarah, Boyd James H, Rea Suzanne, Wood Fiona M
1Burn Injury Research Unit, Faculty Health and Medical Sciences, The University of Western Australia, M318 35 Stirling Highway, Crawley, Perth, Western Australia 6009 Australia.
2Centre for Data Linkage, Curtin University, Perth, Western Australia Australia.
Burns Trauma. 2018 Nov 13;6:32. doi: 10.1186/s41038-018-0134-z. eCollection 2018.
Burns are a devastating injury that can cause physical and psychological issues. Limited data exist on long-term mental health (MH) after unintentional burns sustained during childhood. This study assessed long-term MH admissions after paediatric burns.
This retrospective cohort study included all children (< 18 years) hospitalised for a first burn ( = 11,967) in Western Australia, 1980-2012, and a frequency matched uninjured comparison cohort ( = 46,548). Linked hospital, MH and death data were examined. Multivariable negative binomial regression modelling was used to generate incidence rate ratios (IRR) and 95% confidence intervals (CI).
The burn cohort had a significantly higher adjusted rate of post-burn MH admissions compared to the uninjured cohort (IRR, 95% CI: 2.55, 2.07-3.15). Post-burn MH admission rates were twice as high for those younger than 5 years at index burn (IRR, 95% CI 2.06, 1.54-2.74), three times higher for those 5-9 years and 15-18 years (IRR, 95% CI: 3.21, 1.92-5.37 and 3.37, 2.13-5.33, respectively) and almost five times higher for those aged 10-14 (IRR, 95% CI: 4.90, 3.10-7.76), when compared with respective ages of uninjured children. The burn cohort had higher admission rates for mood and anxiety disorders (IRR, 95% CI: 2.79, 2.20-3.53), psychotic disorders (IRR, 95% CI: 2.82, 1.97-4.03) and mental and behavioural conditions relating to drug and alcohol abuse (IRR, 95% CI: 4.25, 3.39-5.32).
Ongoing MH support is indicated for paediatric burn patients for a prolonged period after discharge to potentially prevent psychiatric morbidity and associated academic, social and psychological issues.
烧伤是一种极具破坏性的损伤，可导致身体和心理问题。关于儿童期意外烧伤后的长期心理健康（MH）数据有限。本研究评估了小儿烧伤后的长期MH住院情况。
这项回顾性队列研究纳入了1980 - 2012年在西澳大利亚州因首次烧伤住院的所有儿童（<18岁）（n = 11,967），以及频率匹配的未受伤对照队列（n = 46,548）。对医院、MH和死亡数据进行了关联分析。采用多变量负二项回归模型生成发病率比（IRR）和95%置信区间（CI）。
与未受伤队列相比，烧伤队列烧伤后MH住院的调整率显著更高（IRR，95% CI：2.55，2.07 - 3.15）。首次烧伤时年龄小于5岁的患者，烧伤后MH住院率是未受伤儿童相应年龄组的两倍（IRR，95% CI 2.06，1.54 - 2.74）；5 - 9岁和15 - 18岁患者的烧伤后MH住院率分别是未受伤儿童相应年龄组的三倍（IRR，95% CI：3.21，1.92 - 5.37和3.37，2.13 - 5.33）；10 - 14岁患者的烧伤后MH住院率几乎是未受伤儿童相应年龄组的五倍（IRR，95% CI：4.90，3.10 - 7.76）。烧伤队列在情绪和焦虑障碍（IRR，95% CI：2.79，2.20 - ）、精神障碍（IRR，95% CI：2.82，1.97 - 4.03）以及与药物和酒精滥用相关的精神和行为状况（IRR，95% CI：4.25，3.39 - 5.32）方面的住院率更高。
小儿烧伤患者出院后需要长期持续的MH支持，以预防潜在的精神疾病以及相关的学业、社交和心理问题。
