Outcomes following burn injury in intensive care patients with major psychiatric disorders |
| |
| Institution: | 1. Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany;2. Department of Human Genetics, Hannover Medical School, Hannover, Germany;1. Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany;2. Department of Human Genetics, Hannover Medical School, Hannover, Germany;1. Tissue Bank and Tissue Therapy Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy;2. Department of Diabetology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy;3. Microbiology Department, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy;1. Regional Burns Centre, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, United Kingdom;2. Hull York Medical School, University of York, Heslington, York YO10 5DD, United Kingdom;1. Division of Population Medicine, School of Medicine, Cardiff University, CF14 4YS, UK;2. CASCADE, School of Social Sciences, Cardiff University, CF10 3BD, UK;3. Centre for Academic Child Health, Bristol Medical School, University of Bristol, BS8 2PS, UK;1. School of Clinical Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa;2. Pietermaritzburg Burn Service, Pietermaritzburg Metropolitan Department of Surgery, South Africa, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa;3. Developing Research, Innovation, Localization and Leadership (DRILL), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa;4. Centre for Teaching & Research in Disaster Medicine and Traumatology (KMC), Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden;5. The Aga Khan University, Pakistan;6. School of Medicine, University of Sāo Paulo, Sāo Paulo, Brazil;7. Department of Surgery, Oregon Health and Science University, United States;8. Department of Surgery, Faculty of Health Sciences, University of Nairobi, Kenya;9. Department of Hand Surgery, Plastic Surgery and Burns in Linköping University, Sweden;10. Department of Biomedical and Clinical Sciences Linköping University, Linköping, Sweden;1. Characteristics Medical Center of PAP, Burn, Frostbite and Tissue Function Reconstruction Institute, 300162 Tianjin, China;2. Neurosurgery Department, No.1 Tianjin Center Hospital, 300162 Tianjin, China |
| |
| Abstract: | AimsPatients with psychiatric comorbidity have been shown to experience high rates of burn injury. Burn epidemiology, etiology, and outcomes have been sparsely documented for patients with major psychiatric disorders. The aim of this study was to analyze the epidemiologic characteristics and outcomes in intensive care burn patients with pre-existing and acute major psychiatric disorders .MethodsA retrospective study was performed including intensive care burn patients admitted between March 2007 and December 2020. Demographic, clinical and epidemiological data were collected and analyzed. Major psychiatric co-morbidities were collected according to ICD-9 and ICD-10 classifications. Patients were stratified according to F-diagnoses.ResultsA total of 1325 patients were included. 16.6 % of all patients had one or more major psychiatric disorders- 9.3 % with anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders, 9.2 % with mood (affective) disorders, 3.5 % with schizophrenia and other non-mood psychotic disorders, and 1.8 % with disorders of adult personality and behavior. Patients with major psychiatric disorders presented with significantly higher burn severity, reflected by higher abbreviated burn severity index (ABSI) scores (5.9 vs. 5.3, p < 0.001) and larger total body surface area (TBSA) affected (15.9 vs. 12.5 %, p = 0.002). Burned TBSA ≥ 30 and inhalation injuries were observed more frequently in patients with MDP, however without statistical significance. They also experienced prolonged hospital length-of-stay (LOS) (25.5 vs. 16.3 days, p < 0.001), prolonged intensive care unit LOS (14.8 vs. 7.7 days, p < 0.001), underwent surgical interventions (3.5 vs. 2.3, p < 0.001) and mechanical ventilation more frequently (34.1 % vs. 16.5 %, p = 0.43) and had significantly longer ventilation durations (73.5 vs. 31.2 h, p = 0.002). Mortality rates were lower compared to patients without major psychiatric disorders (5.9 vs. 8.1, p < 0.001).ConclusionsThe prevalence of major psychiatric disorders in burn patients is considerably high. Patients with psychiatric comorbidities were found to have greater burn severity, prolonged total hospital and ICU LOS, underwent surgical interventions and mechanical ventilation more frequently and had prolonged ventilation duration. Our results highlight the importance of identifying burn patients with major psychiatric disorders who may necessitate additional resources and require extensive inpatient psychiatric care and counseling. |
| |
| Keywords: | Burn patients Major psychiatric disorders Burn intensive care Length-of-stay Pre-existing psychiatric disorder psychiatric comorbidity |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
