RESUMO
OBJECTIVES: To investigate the determinants of mortality and the lethal area 50 (LA50) in large series of Iranian burn patients admitted to a single burn center. METHODS: This cross-sectional study was conducted in Shahid Motahari burn center of Tehran, Iran during a 1-year period from 2011 to 2012. We included all the burn patients who were admitted to our center during the study period. Those with incomplete medical records and those referred to other centers were excluded from the study. The medical records of the included patients were reviewed and the demographic, clinical, laboratory and outcome measures were recorded. The mortality rate was recorded and the determinants of LA50 were analyzed in a univariate and stepwise multivariate model. RESULT: Overall we included a total number of 1200 subjects with mean age of 30.8 ±18 years. There were 907 (75.6%) men and 293 (24.4%) women among the patients. The total LA50 was 55.5% (95% CI: 52.98%-58.3 %). There was a significant difference between age group >61 years and two 11-20 and 21-30 groups regarding LA50. The advanced age (p<0.001), female gender (p=0.002), inhalational injury (p<0.001) and burn extension determined by TBSA% (p<0.001) were significantly associated with mortality. In addition, male gender (p=0.087), flame (p=0.156), scald (p=0.088) and chemical injuries (p=0.071) were not associated with mortality. CONCLUSION: The LA50 determine din our study is still much lower than that reported in developed countries, as a result, the quality of medical care is lower. Female gender, age, inhalational injury and extension of burn determined by TBSA% were found to be the independent risk factors of mortality in burn patients in our series.
RESUMO
OBJECTIVE: The aim of this study was to examine epidemiologic characteristics of suicidal behavior by burns requiring hospitalization in the province of Ilam, Iran. METHODS: A prospective population-based study of all suicidal behaviors by burns requiring hospitalization was conducted in the province of Ilam, Iran, from March 21, 2005 to March 20, 2006. Data were obtained from patients, family members, and/or significant others through interviews during the course of hospitalization. RESULTS: A total of 51 patients with suicidal behavior by burns requiring hospitalization were identified during the study period, representing an overall incidence rate of 12.5 per 100,000 person-years (P-Y) (95% confidence interval [CI]: 9.1-16.0 per 100,000 P-Y). Women had a higher rate of suicidal behavior by burns than men (18.0 vs. 7.2 per 100,000 P-Y) (P < 0.001). The age-specific rate of suicidal behavior by burns peaked at age group 20-29 years (19.3 per 100,000 P-Y). The rate of suicidal behavior by burns was slightly higher among married persons than single persons, although not statistically significant (13.5 vs. 9.8 per 100,000 P-Y) (P = 0.25). The rate of suicidal behavior by burns among the rural population was significantly higher than the urban population (17.9 vs. 9.3 per 100,000 P-Y) (P = 0.02). The most frequent precipitating factor for suicidal behavior was marital conflicts. CONCLUSIONS: The high rate of suicidal behavior by burns among young, married women in Ilam is an alarming social tragedy. Despite substantial efforts toward improving health and human rights, persistent conditions allow violence against women in Iran and these women continue to turn to the desperate remedy of self-burning. Findings of this study highlight the need for the implementation of a well-organized approach to reduce the incidence of suicide by burns.