Abstract
Does Voltage Predict Return to Work and Neuropsychiatric Sequelae Following Electrical Burn Injury?
Increased voltage in electrical injuries causes higher morbidity and mortality. This retrospective study compared high-voltage and low-voltage electrical burns in an effort to assess whether neuropsychiatric sequelae also worsened with increasing voltage. The authors reviewed charts of patients presenting with electrical burns to a regional burn center over a 5-year period. They defined neuropsychiatric sequelae as neuropathic pain, insomnia, nerve compression, major depressive disorder, posttraumatic stress syndrome (PTSD), memory loss, anxiety disorder, and seizures.
In total, 115 charts were reviewed and, for comparison, separated into greater than 1000 V (60), less than 1000 V (25), electrical arc injury where voltage is difficult to estimate (29), and lightning strike (1). In regards to neuropsychiatric sequelae, there was no statistical difference between the high-voltage group (48%) and the low-voltage group (44%). Neuropathic pain was most commonly seen in both groups. As expected, overall morbidity was higher in the high-voltage group than the low-voltage group with statistically significant increases in the length of hospital stay, length of intensive care unit stay, amputation, and fasciotomy.
With 115 patients, this study may have been underpowered to demonstrate a statistical difference between the two groups. For example, there were 6 cases of PTSD in the high-voltage group but none in the low-voltage group. Nonetheless, as the authors state, this study does make an argument for long-term neuropsychiatric care to help supplement burn care in all electrical burn victims given the high rates of neuropsychiatric sequelae.
(Ann Plast Surg. 2010;64:522–525) S Chudasama, J Goverman, JH Donaldson, et al.
Prepared by Anil Menon, MD, UTMB/NASA Aerospace Medicine Fellow, Galveston, TX, USA