Population Level Impact of Self-Immolation on Burn Unit Resources: A Retrospective Case-Matched Study

Background: This investigator sought to enhance medical knowledge and clinical care by distinguishing the population level characteristics of patients who attempted self-immolation within the burn population and determine the impact these patients have on health-care related resource utilization. Methods: Patients who met the inclusion criteria and were admitted for a documented attempt of self-immolation were case-matched based on age, gender, total body surface area burn, inhalation injury, and burn mechanism to individuals who experienced accidental burn injuries and were admitted to the burn unit during the same time-period. To compare patients, this investigator matched patient groups using a propensity score method. Results: Seventy-two total patients, including matched pairs, were selected after propensity scoring. Self-immolation patients had a significant difference in preexisting history of depression (p = .008), psychiatric disease (p = .028) and previous psychiatric treatment (p \u3c .001) as compared to accidental burn injury patients. They were also more likely to present with a history of anxiety (OR = 1.8), drug abuse (OR = 2.5) and alcohol abuse (OR = 2.8). Longer length of stay and the need for more specialty consult services visits (p = .002), and higher rates of complications (p = .013) were also found among self-immolation patients. Self-immolation patients were twice as likely to experience greater burn depth with differences in full thickness burn admissions (OR = 2.2). Self-immolation patients required more concomitant surgical procedures than accidental burn injury patients (p = .024) and were nearly three times as likely to be readmitted (OR = 2.82) to the hospital with longer hospital stays during readmission in comparison with accidental burn patients (15 days vs. 9 days). Conclusion: Self-immolation patients had distinguishable differences in patient levelcharacteristics and utilized more burn unit health-related resources as compared to matched accidental burn injury patients