Burns in substance abusers and in neurologically and mentally impaired patients.

Drug and alcohol abusers, psychiatric patients, and those with neurologic dysfunction represent a large proportion of burn victims, but little is known about the impact of these conditions on burn morbidity. We wanted to determine whether this group has more complications, more surgical procedures, and longer hospital stays than other burn patients. We also wanted to find out if it cost more to care for these patients. A retrospective study of 180 patients admitted from January 1, 1986, to September 1, 1986, revealed that 51 (28%) of our patients had one or more of these impairments. The impaired and control groups were similar in the size of burn and the proportion of third-degree burns. The impaired group was much more likely to have flame burns and was somewhat older. The impaired patients stayed in the hospital nearly twice as long, had 60% more operations, and were twice as likely to have complications. No difference was seen in the frequency of death.