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Burn recidivism:a 10-year retrospective study characterizing patients with repeated burn injuries at a large tertiary referral burn center in the United States

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Burns & Trauma 2019年第1期7卷 75-84页

作者： Sarah L.Laughon Bradley N.Gaynes Lori P.Chrisco Samuel W.Jones Felicia N.Williams Bruce A.Cairns Gary J.Gala Department of psychiatry 101 Manning DriveCB#7160Chapel HillNC 27599-7160USA Department of Surgery 4001 Burnett-Womack BuildingCB#7050Chapel HillNC 27599-7050USA North Carolina Jaycee Burn Center 101 Manning DriveCB#7206Chapel HillNC 27599-7600USA

Background:Psychiatric and substance use disorders are common among trauma and burn patients and are known risk factors for repeat episodes of trauma,known as trauma *** epidemiology of burn recidivism,specifically,has not been *** study aimed to characterize cases of burn recidivism at a large US tertiary care burn center and compare burn recidivists(RCs)with non-recidivists(NRCs).Methods:A 10-year retrospective descriptive cohort study of adult burn patients admitted to the North Carolina Jaycee Burn Center was conducted using data from an electronic burn registry and the medical *** variables were reported using medians and interquartile ranges(IQR).Chi-square and Wilcoxon-Mann-Whitney tests were used to compare demographic,burn,and hospitalization characteristics between NRCs and ***:A total of 7134 burn patients were admitted,among which 51(0.7%)were RCs and accounted for 129(1.8%)*** the 51 RCs,37 had two burn injuries each,totaling 74 admissions as a group,while the remaining 14 RCs had between three and eight burn injuries each,totaling 55 admissions as a *** to NRCs,RCs were younger(median age 36 years vs.42 years,p=0.02)and more likely to be white(75%vs.60%,p=0.03),uninsured(45%vs.30%,p=0.02),have chemical burns(16%vs.5%,p<0.0001),and have burns that were≤10%total body surface area(89%vs.76%,p=0.001).The mortality rate for RCs *** did not differ(0%vs.1.2%,p=0.41).Psychiatric and substance use disorders were approximately five times greater among RCs compared to NRCs(75%vs.15%,p<0.001).Median total hospital charges per patient were nearly three times higher for RCs ***($85,736 vs.$32,023,p<0.0001).Conclusions:Distinct from trauma recidivism,burn recidivism is not associated with more severe injury or increased *** to trauma recidivists,but to a greater extent,burn RCs have high rates of comorbid psychiatric and medical conditions that contribute to increased health care u

关键词： Burn recidivism consult psychiatry Substance use disorder Repeat burn injury

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