Influencing Factors And Predictive Models Of Suicidal Ideation In Burn Patients

Objective:The intense injury experience of burn patients,the painful process of wound treatment,and the long recovery period after discharge may cause burn patients to have suicidal ideation.However,few studies have directly assessed suicidal ideation in burn patients,and there are few studies on specific contributing factors.The purpose of this study was to investigate the influencing factors of burn patients with suicidal ideation and establish a preliminary prediction model.Methods:A total of 194 burn patients were included in this study.hamilton depression scale(HAMD),hamilton anxiety scale(hamilton anxiety scale,HAMA),acute stress disorder scale(ASDS),insomnia severity index,ISI)and burn specific health scale-brief(BSHS-B)were used to evaluate depression,anxiety,stress,insomnia,burn,etc.General information was also collected on the patients,including sex,age,years of education,BMI,smoking,burn area and burn severity.Baseline characteristics between groups were compared by the Mann-whitney U test and the Chi-square test,and correlations were compared by Cramer’s V and Spearman’s tests.Univariate Logistic regression screened meaningful variables and further conducted multivariate Logistic regression modeling,ROC analysis to evaluate model differentiation,and internal validation.Results:In this study,among 194 burn inpatients,there were 21 cases of suicidal ideation and 173 cases of no suicidal ideation.The incidence of suicidal ideation in burn inpatients was 10.82%(21/194).The results showed that there were statistical differences in gender,trunk burn,burn severity,ISI score,HAMD score,HAMA score,ASDS score and BSHSB score between the two groups(P<0.05),while there were no significant differences in other variables(P>0.05).The correlation analysis results showed that there was a correlation between suicidal intention and gender(rv=0.146,P=0.042),severity of burn(rv=0.275,P=0.002),trunk burn(rv=0.171,P=0.017),ISI score(rs=0.257,P<0.001),HAMD score(rs=0.306,P<0.001),HAMA score(rs=0.381,P<0.001)and ASDS score(rs=0.259,P<0.001)were positively correlated with BSHS-B score(rs=-0.236,P=0.001)showed a negative correlation.Univariate logistic analysis results showed that gender,burn severity,trunk burn,ISI score,HAMD score,HAMA score,ASDS score and BSHSB score were influential variables(all P<0.05).Further multivariate Logistic regression analysis results showed that:Burn severity in burn patients(moderate burn:OR=0.103,95%CI:0.019-0.565,P=0.009;Severe burns:OR=0.351,95%CI:0.065-1.888,P=0.223 Extra severe burns:OR=0.103,95%CI:0.007-1.484,P=0.095)and HAMA score(OR=1.136,95%CI:1.035-1.246,P=0.007)was an independent factor for burn patients with suicidal ideation.The Logistic regression prediction model was established through two independent influencing factors,namely burn severity and HAMA score.ROC analysis results showed that the models were well distinguished(AUC=0.880,95%CI:0.808-0.952,P<0.001),and the internal verification accuracy was 79.38%.Conclusion:The independent influencing factors of suicidal ideation in burn patients are burn severity and HAMA score,which is expected to help us detect suicidal ideation in burn patients as early as possible,and provide a basis for clinical timely development of prevention and treatment measures.