Manasyan Artur, Malkoff Nicolas, Cannata Brigette, Stanton Eloise W, Yenikomshian Haig A, Gillenwater T Justin, Stoycos Sarah A
Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA 90033, USA.
J Burn Care Res. 2025 Mar 4;46(2):386-392. doi: 10.1093/jbcr/irae168.
Despite the growing recognition of self-harm as a pressing public health issue, demographic risk factors of self-inflicted burn (SIB) injuries in the United States have not been extensively described. In this retrospective study, we seek to identify demographic risk factors and patterns associated with SIB injuries at an urban burn center. Charts were reviewed of patients admitted to a single American Burn Association-verified burn unit between 2015 and 2023 with a history of SIB injury, identified with ICD10 code X76.XXXA. Descriptive statistics, Welch's t-test of unequal variances, and chi-squared analysis were performed. A total of 3212 patients were admitted to our institution for the management of acute burn injury, with 94 (2.9%) patients presenting with SIB injury. SIB patients were more likely than the control cohort to be male (P = .035), single (P = .008), unhoused (P < .001), live alone (P < 0.001), and have documented psychiatric diagnoses (72.3% vs 2.1%, P < .001). They had larger %TBSA affected (P < .001) and higher rates of inhalation injury (P < .001). The SIB cohort also showed significantly higher rates of positive urine toxicology results, primarily for stimulants and opiates (P < .001). Patients with SIBs had longer hospital stays (21.7 ± 2.6 days vs 12.0 ± 22.1 days, P = .006), higher rates of ICU admission (P < .001), and mechanical ventilation requirement (P < .001). Mental health support services, substance abuse rehabilitation programs, and community outreach need to be prioritized, especially targeting vulnerable populations such as the unhoused.
尽管自残作为一个紧迫的公共卫生问题越来越受到重视，但美国自残烧伤（SIB）伤害的人口统计学风险因素尚未得到广泛描述。在这项回顾性研究中，我们试图确定城市烧伤中心与SIB伤害相关的人口统计学风险因素和模式。对2015年至2023年期间入住一家经美国烧伤协会认证的烧伤科且有SIB伤害史（通过ICD10代码X76.XXXA识别）的患者病历进行了审查。进行了描述性统计、方差不等的韦尔奇t检验和卡方分析。共有3212名患者因急性烧伤损伤入住我们的机构，其中94名（2.9%）患者存在SIB伤害。与对照组相比，SIB患者更可能为男性（P = 0.035）、单身（P = 0.008）、无家可归（P < 0.001）、独居（P < 0.001），且有记录在案的精神疾病诊断（72.3%对2.1%，P < 0.001）。他们的烧伤总面积百分比更大（P < 0.001），吸入性损伤发生率更高（P < 0.001）。SIB队列的尿液毒理学阳性结果率也显著更高，主要是兴奋剂和阿片类药物（P < 0.001）。SIB患者的住院时间更长（21.7±2.6天对12.0±22.1天，P = 0.006），入住重症监护病房的比例更高（P < 0.001），且需要机械通气（P < 0.001）。需要优先提供心理健康支持服务、药物滥用康复项目和社区外展服务，尤其是针对无家可归等弱势群体。
