First, we went through The National Care Register for Health Care (Hilmo) records from 2011 to 2015 to find all patients in Finland with both burn and self-harm ICD10 codes. Then we investigated the medical records of all patients treated at the National Burn Centre (NBC) in Helsinki in the period 2011-2020. Patients admitted to the hospital because of self-harm burn injuries were compared to those without self-harm injuries. Patients below 18 years old were excluded.
The Hilmo register consisted of a total of 3391 adult burn patients admitted to any healthcare unit during the study period. Compared with non-self-harm patients, self-harm patients (N = 82) had lower mean age (41 years vs 54 years, p < 0.001) and longer hospitalization (18 days vs. 6 days, p < 0.05). Two-thirds of the self-harm patients (N = 38) admitted to the NBC in the period 2011-2020 had a pre-burn history of psychiatric care (66%) and one-third of them had a previous record of self-harm or suicide attempt. Men had more severe burns than women (mean TBSA 46% vs. 14%, p < 0.05), and seven of them died during the first 48 h of care, but this was not the case for any female patient.
Self-harm burn patients were younger and had longer hospitalization at all care levels than other burn patients. Based on medical records of hospitalized self-harm burn patients, we found clear gender differences in the severity of the burn injury and in mortality, with men suffering more severe injuries, in some cases leading to death. Recognizing high-risk patients pre-burn could have a strong preventive impact.
方法:首先,我们查阅了2011年至2015年的国家医疗护理注册(Hilmo)记录,发现芬兰的所有患者同时具有烧伤和自残ICD10代码.然后,我们调查了2011-2020年期间在赫尔辛基国家烧伤中心(NBC)接受治疗的所有患者的医疗记录。将因自我伤害烧伤而入院的患者与没有自我伤害的患者进行比较。18岁以下的患者被排除在外。
结果:Hilmo登记簿包括研究期间任何医疗机构收治的3391名成年烧伤患者。与非自我伤害患者相比,自我伤害患者(N=82)的平均年龄较低(41岁vs54岁,p<0.001)和更长的住院时间(18天vs.6天,p<0.05)。在2011-2020年期间,接受NBC治疗的自我伤害患者中有三分之二(N=38)有烧伤前精神病治疗史(66%),其中三分之一有自我伤害或自杀企图的记录。男性比女性有更严重的烧伤(平均TBSA46%vs.14%,p<0.05),其中7人在最初的48小时内死亡,但对于任何女性患者来说都不是这样。
结论:与其他烧伤患者相比,自我伤害烧伤患者更年轻,住院时间更长。基于住院自残烧伤患者的病历,我们发现烧伤的严重程度和死亡率存在明显的性别差异,男人遭受更严重的伤害,在某些情况下导致死亡。认识到高危患者烧伤前可能会产生强烈的预防影响。