• Gabrielle Kang-Auger, Daniel E Borsuk, Nancy Low, Aimina Ayoub, Nathalie Auger, and Stéphane Buteau.
• Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.
• Ann. Surg. 2024 Mar 20.

ObjectiveTo determine the association between burns and hospitalization for mental health disorders up to three decades later.Summary Background DataBurns are associated with pain, disability, and scarring, but the long-term impact on mental health is unclear.MethodsWe analyzed a cohort of 23,726 burn patients aged ≥10 years who were matched to 223,626 controls from Quebec, Canada, between 1989 and 2022. The main exposure was admission for a burn. We followed patients during 3,642,206 person-years of follow-up to identify future hospitalizations for psychiatric disorders, substance use disorders, and suicide attempts. We estimated adjusted hazard ratios (HR) with 95% confidence intervals (CI) for the association between burns and subsequent mental health hospitalization using Cox proportional hazards regression.ResultsBurn patients had 1.76 times greater risk of mental health hospitalization over time (95% CI 1.72-1.81), compared with controls. Associations were present regardless of burn site, but were greatest for burns covering ≥50% of the body (HR 3.29, 95% CI 2.61-4.15), third degree burns (HR 2.04, 95% CI 1.94-2.14), and burns requiring skin grafts (HR 2.00, 95% CI 1.90-2.10). Compared with controls, burn patients had more than two times the risk of hospitalization for eating disorders (HR 3.14, 95% CI 2.50-3.95), psychoactive substance use disorders (HR 2.27, 95% CI 2.17-2.39), and suicide attempts (HR 2.42, 95% CI 2.23-2.62). Risks were particularly elevated within 5 years of the burn, but persisted throughout follow-up.ConclusionsBurns are associated with an increased risk of hospitalization for mental health disorders up to 30 years later.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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