71 Standardized Suicide Screening in Adult Burn Patients to Determine Risk

• Published in: Journal of burn care & research 2019-03, Vol.40 (Supplement_1), p.S48-S49
• Main Authors: Taveras, L R, Imran, J B, Cunningham, H B, Pickett, M L, Madni, T D, Clark, A T, Ahmed, F, Phelan, H A, Cripps, M W, Roaten, K
• Format: Article
• Language: English
• ISSN: 1559-047X; 1559-0488
• DOI: 10.1093/jbcr/irz013.073

Abstract Introduction Pre-morbid psychiatric disorders are common among burn survivors and psychiatric symptoms often persist or worsen post-injury, leading to increased suicide risk. The prevalence of suicide risk is unknown and providers caring for burn survivors do not routinely screen for suicide risk and may miss the opportunity for early intervention to prevent injury or death. The characteristics of at-risk burn patients have yet to be elucidated. Using a brief, standardized tool to identify at-risk patients may be an important first step in reducing risk. The aims of this study are to report the prevalence of suicide risk in burn patients and identify demographic and burn-related characteristics of these patients. Methods The Columbia-Suicide Severity Rating Scale, screener version, recent (C-SSRS) was administered by nursing staff to burn patients 18 and older upon admission, or as soon as clinically feasible. Adult burn patients with screening data between February 2015 and February 2018 were included. Patients were classified as at risk if any item was positively endorsed on the C-SSRS and no risk if all responses were negative. Significance was set at α = 0.05. Statistical analysis was performed using Student t test and χ2 test where appropriate. Results Out of 1,474 burn patients evaluated during the study period, 1,444 (97.96%) were screened for suicide risk. Suicide risk was identified in 64 (4.43%) patients. At-risk patients did not have a partner (n = 52, 81.25%), had higher TBSA (16.25% vs 9.23% and had a longer LOS (24.4 days vs 8.6). Overall, female patients had higher proportion of at risk status (8.21% vs 3.23%, p < 0.05). There were no differences in age, race/ethnicity, payor status and mortality. Conclusions Our universal suicide screening process identifies an at risk subpopulation of burn patients. Higher injury burden and poor social support system are associated with suicide risk. Applicability of Research to Practice Our findings suggest that a portion of patients admitted for burn injuries endorse suicide risk factors. This risk may go undetected without standardized screening. These findings suggest at risk patients may be identified by standardized screening tools and referred for appropriate management and follow-up.