Bensaida L, Sabur S, Baya S, Mazouz S, Gharib N, Abbassi A
Service de Chirurgie Plastique et Réparatrice, CHU Ibn Sina, Raba, Maroc.
Ann Burns Fire Disasters. 2019 Sep 30;32(3):179-183.
Psychiatric disorders in burn victims are well known and studied, but few articles treat the impact of pre-existing psychiatric pathologies on the evolution of burns. The aim of our study is to compare the evolution in terms of complications, length of stay and survival between patients with and without pre-existing mental disorders. This is a bi-centric case-control study (N = 92), conducted at the Plastic Surgery Department of Rabat University Hospital, and the Plastic Surgery Department of the Tangier-Morocco Regional Hospital, between January 2012 and February 2018. Characteristics of the patients were collected and two groups of patients were identified and compared (n = 67): a preexisting mental disorder group (n = 22) and a control group (n = 45). TBSA (total body surface area) burned and 2nd and 3rd degree burned TBSA were significantly greater in the group with a history of mental disorders compared to the control group (p = 0.012, p <0.001, p = 0.014). Mean length of stay before discharge was greater (p = 0.005). Finally, mortality in the group with pre-existing mental illness was 31.8% versus 6.7% in the control group (p = 0.011). Patients with pre-existing mental disorders seem to present worse burns and need more time to recover from them, resulting in higher morbidity and mortality and a higher cost of care. The systematic screening of burned patients in search of a psychiatric diagnosis and early management of these disorders could improve the prognosis and quality of life of these patients.
烧伤患者的精神障碍已广为人知并得到研究,但很少有文章探讨既往精神病理学对烧伤病程的影响。我们研究的目的是比较有无既往精神障碍患者在并发症、住院时间和生存率方面的病程。这是一项双中心病例对照研究(N = 92),于2012年1月至2018年2月在拉巴特大学医院整形外科和摩洛哥丹吉尔地区医院整形外科进行。收集患者的特征,并确定和比较两组患者(n = 67):既往精神障碍组(n = 22)和对照组(n = 45)。与对照组相比,有精神障碍病史的组烧伤总面积(TBSA)以及二度和三度烧伤TBSA显著更大(p = 0.012,p <0.001,p = 0.014)。出院前平均住院时间更长(p = 0.005)。最后,既往有精神疾病组的死亡率为31.8%,而对照组为6.7%(p = 0.011)。有既往精神障碍的患者似乎烧伤情况更严重,需要更多时间恢复,导致更高的发病率和死亡率以及更高的护理成本。对烧伤患者进行系统筛查以寻找精神科诊断并对这些疾病进行早期管理,可能会改善这些患者的预后和生活质量。