Burns in Alcohol and Drug Users Result in Longer Treatment Times with More Complications

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Abstract
Brezel, Kassenbrock, and Stein (J BURN CARE REHABIL 1988;9:169-71), surveyed a group of 180 patients who were substance abusers or who were neurologically or mentally impaired and found that their inpatient care was more costly, more complicated, and more lengthy. In our institution we undertook a similar study to determine whether our findings would be similar. During a 12-month period, the charts of all patients over the age of 18 who were admitted for treatment of acute burns were reviewed. One hundred and thirty-one charts were available for study. Review of the charts revealed that 19 (14.5%) met our criterion of being impaired by drugs or alcohol, and the remaining 112 patients served as control subjects. The total body surface area burn averaged 25.8% in the impaired group and 21.3% in the control group. The amount of third-degree burns averaged 11% in the impaired group and 11% in the control group. Although the amount of third-degree burns was virtually identical in the two groups, the control group required an average of 1.2 procedures per patient, whereas the impaired group required 2.1 procedures per patient. A list of possible complications or adverse reactions that could occur was used to compare the two groups. The control group averaged 1.83 complications per patient, and the impaired group averaged 3.16 complications per patient. The average length of stay in the hospital for the control group was 19 days, and the average length of stay for the impaired group was 34.1 days. In summary, patients who were impaired by drugs or alcohol had a significantly lengthened hospital stay, required 50% more surgical procedures, and had twice the complication rate as nonimpaired patients with the same amount of third-degree burns.

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