Citation

Yamamoto R, Shibusawa T, Kurihara T, Sasaki J. J. Burn Care Res. 2019; 40(2): 228-234.

Affiliation

Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan.

Copyright

(Copyright © 2019, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1093/jbcr/irz009

PMID

30649382

Abstract

Self-inflicted burn accounts for considerable morbidity and mortality in more economically developed countries, and there is a substantial debate regarding the pathophysiological relevance between self-inflicted burns and unfavorable outcomes. To validate whether self-inflicted injury is an independent predictor of high mortality regardless of the severity of burn, we conducted a retrospective observational study using the Japan Trauma Data Bank, a nationwide database including over 200 major tertiary care centers. Among 2,006 patients with burn who had arrived at collaborating centers between 2004 and 2016, we included patients aged ≥ 15 years, those who did not present with cardiopulmonary arrest upon arrival, and those who had ≥10% total body surface area burns. Patients with missing survival data or unknown mechanism of injury were excluded. In total, 1,094 patients were eligible, of whom 222 (20.3%) had self-inflicted burns. The patients were divided into the self-inflicted and non-self-inflicted groups, and propensity score was calculated using the demographic information of the patients, injury variables, time from injury to hospital arrival, and other survival predictors. Via a propensity score matching, 98 pairs were selected, and the self-inflicted group had a higher mortality than the non-self-inflicted group (43.9% vs. 28.6%, hazard ratio = 1.77; 95% confidence interval = 1.10-2.86; p = 0.02). Inverse probability weighting and multivariate logistic regression were performed as sensitivity analyses, and results validated that self-inflicted burn was independently associated with increased in-hospital mortality. Therefore, patients with self-inflicted burns should receive judicious management, regardless of burn injury severity.

Language: en