Psychiatric comorbidity in hospitalised burn patients: A Portuguese population-based observational retrospective study (2000-2015)

Background Burn injuries significantly impact health-related quality of life. However, psychiatric comorbidities among hospitalised burn patients remain understudied. Objective To evaluate the prevalence of psychiatric comorbidities in hospitalised burn patients in Portugal and investigate their association with burn injury characteristics, hospital outcomes, and readmission rates. Methods A retrospective, population-based observational study was conducted using nationwide administrative data on adult burn hospitalisations in mainland Portugal (2000–2015). Secondary diagnoses were identified using the Clinical Classification Software (mental disorder categories 650–670). Hospitalisation outcomes (length of stay, in-hospital mortality), readmission rates, and burn injury characteristics were compared using Mann-Whitney U and Chi-squared tests. Results Of 18,161 burn hospitalisations, 12.9% (n=2335) involved psychiatric comorbidities. Patients with psychiatric disorders had significantly longer hospital stays (median: 18 vs. 10 days, p<0.001), higher in-hospital mortality (7.9% vs. 5.2%, p<0.001), and increased rates of self-inflicted and inhalation injuries. These patients also sustained more severe burns, with ≥20% total body surface area (TBSA) involvement being more prevalent (19.1% vs. 15.7%, p<0.001). Schizophrenia and other psychotic disorders, alcohol-related disorders, and delirium, dementia, and amnestic disorders were notably linked to poorer outcomes. Conclusion Psychiatric comorbidities in burn patients are associated with prolonged hospitalisation, increased mortality, and higher readmission rates. These findings underscore the need for early psychiatric screening and integrated multidisciplinary care to improve clinical outcomes and reduce the healthcare burden. • Psychiatric disorders increase burn risk, especially from fire. • Patients with psychiatric disorders suffer more severe burns and higher death rates. • Patients with psychiatric disorders have more trunk, ankle/foot burns, and self-harm. • Patients with psychiatric disorders have longer hospital stays and more readmissions. • Schizophrenia, alcohol use, and dementia increase burn severity and risks.