Assault by burning - a reappraisal

Assault by burning is a serious form of trauma that often results in higher incidence of inhalation injury, longer intensive care unit (ICU) and hospi tal stay, and higher mortality rate than is observed in the general burn po pulation. We evaluated the epidemiology and outcome of assault burn victims treated in a tertiary burn center over a 6-year period. Among the 1063 acu te burn patients who had been admitted to the Burns Unit between March 1993 and February 1999, 28 (2.6%) had assault burn injuries either by scald, ch emical or fire. The mean extent of burn was 21.9%+/- 20.8% (range 2-90%) to tal body surface area and the mean length of hospital stay was 65.2 +/- 107 .3 days (range 1-565). Nineteen out of 25 patients (67.9%) underwent 76 ope rations. Nine patients had inhalation injuries requiring intubation and ICU admission. Three patients died in the series, which yielded a mortality ra te of 10.7%. Compared to the general burn population. the assault burn grou p had significantly larger burn size (P < 0.001), higher incidence of inhal ation injury (P < 0.001), longer ICU and hospital stay (P < 0.001), and hig her mortality rate (P < 0.005). When these 28 victims were grouped accordin g to the type of assault burn injury into a fire group, chemical group and scald group, all the 9 ICU admission and the 3 mortalities belonged to the fire group. Assault by fire resulted in larger burn size (P = 0.03). more i nhalation injury (P < 0.001) and longer ICU stay (P = 0.02). Although the f ire group had a longer hospital stay and higher mortality rate, this was st atistically insignificant. (C) 2001 Published by Elsevier Science Ltd on be half of ISBI.