Kind Of Trauma Research Articles

Social services trauma?

The essay puts forward the thesis that contemporary Polish social services (social work) suffer from a kind of trauma, the source of which is their cutting off from their historical roots and, consequently, the deprivation of a tradition that has institutional continuity. This state of affairs is one of the sources of their continuing weakness. Polish social services traditions emerged in the period up to the outbreak of World War II, and they were formed by three strands – three types of institutionalized social practice, each of which also had its own development potential. These were: the social care strand growing out of the experience of 19th-century public charity, the people's house movement, and the social work strand developed in the 1930s among graduates of the Study of Social and Educational Work. As a result of the War, and then stalinism, almost all of this output was destroyed; the institutional continuity of the people's house movement and social work was irretrievably broken, only the tradition of social care was referred to. Within this framework, the profession of social worker was created in the 1960s – so to speak – from scratch, the institutional design of which was – and remains today – based on the 19th-century model of visitors of the poor.

Incidence of Polytrauma in the Casualty Emergency Department of a Tertiary Care Hospital in Dhaka City

Background: Polytrauma is a public health problem in every country. Objective: The purpose of the present study was to assess the incidence of Polytrauma in the Casualty Emergency Department of a tertiary care hospital in Dhaka city. Methodology: This cross-sectional study was carried out in the casualty of Emergency Department of Dhaka Medical College Hospital, Dhaka, Bangladesh. The patients who were admitted from January 2014 to December 2014 were included in this study. This study includes all the patients with polytrauma, most of whom underwent laparotomy or other types of surgery like suprapubic cystostomy, amputation, surgical toileting, chest drainage, but a small number was managed with non-operative approach. Immediately after admission, the patients were subjected to resuscitation, primary survey and history taking including pre-hospital retrieval. A tabulated sheet of questionnaire was given to all the patients and answer was taken by conversation and examination. Results: A total number of 100 patients were recruited for this study. The mean age with SD of the study population was 33.5±12.5 with the range of 3 to 67 years. The male female ratio is 7.33:1. The victims of polytrauma sustained their injury from different kinds of trauma. Out of hundred cases with polytrauma, road traffic accidents was the most common cause which included motor vehicle accident, pedestrian and motor cycle accident and resulted in a total of 63 casualty occupying 63% of the entire series. Polytrauma resulted fall from height occurred in 10 (10%) cases. Stab injury caused polytrauma in 5 (5%) cases. Conclusion: In conclusion majority of the study population is young adult with the predominance of male presented with road traffic accident. Journal of Current and Advance Medical Research, July 2023;10(2):60-64

RECENT RESEARCH ON THE CONCEPT OF THE HRIDAYA IN RACHANA SHARIRA, AND ITS RELATION WITH MODERN ANATOMY

Ayurveda states that Hridaya is one of the most important parts of the mortal body. An injury to it may affect it in severe conditions. The specific signs and symptoms of these conditions are well defined in Samhitas. Any kind of trauma or injury to it may lead to death. Therefore, it has been classified under Tri Marma and Dashsa pranayatana. Dwivedi & Kumar (2010). The term Hridaya indicates the organ which regulates the circulation of Prana throughout the body by collecting and diffusing rhythmically. Samhitas state that Hridaya performs several other functions along with the circulation of Prana (blood/ oxygen). These ancient classics mention that Hridaya controls the mortal body, sensations, and powers of logic, becoming the center of life and wit. Hence at one point the term Hridaya is considered as brain. Acharya Charaka and Sushruta have considered the Hridaya as a Koshthanga (organ present in Koshtha/trunk). This easily indicates that Hridaya is nothing but Urastha Hridaya (organ present in Koshtha/trunk). In this composition, an attempt has been made to connect references about Hridaya to modern anatomy through logical analysis of these references.

LUXAÇÃO TRAUMÁTICA ATLANTO-OCCIPITAL COM MELHORA DO DÉFICIT NEUROLÓGICO: RELATO DE CASO

ABSTRACT Traumatic atlanto-occipital dislocation is a rare, severe, and usually fatal injury. In this paper, we report the case of a 28-year-old patient with multiple trauma, who suffered an atlanto-occipital dislocation (AOD) associated with rotatory dislocation at C1-C2, condyle fracture and traumatic brain injury resulting from a car accident, with a cardiopulmonary arrest at the accident site. The patient had motor and sensory deficits, suffering other complications of clinical severity during hospitalization. After two years of surgical treatment follow-up, the patient had a complete recovery of neuromotor and sensory functions. This case demonstrates that neurological recovery with minimal sequelae is possible, even after an unfavorable prognosis resulting from a severe injury with a high risk of death as this kind of trauma. It is essential for health professionals to have the ability to identify and treat AOD, ensuring improved clinical outcomes, reducing mortality and morbidity, and providing a better life to affected patients. Level of Evidence IV; Cases Series.

Triggered Pemphigus with Koebner Phenomenon: A Coincidence?

Abstract Pemphigus includes a group of autoimmune bullous diseases of skin and/or mucous membranes characterized by intraepidermal acantholytic blisters. The onset and course of pemphigus vulgaris (PV) depend on a variable interaction between predisposing and inducing/triggering factors. Genetic predisposition has an important role and is alone not sufficient to initiate the autoimmune mechanism. The interference of inducing or triggering environmental factors seems to be crucial to set out the disease. Triggering of PV by physical agents, contact allergens, dietary factors, and emotional stress are rare, but well-documented events. The Koebner phenomenon (KP), which is described as the appearance of typical skin lesions of a certain dermatosis in uninvolved skin as a result of different kinds of trauma, is rarely documented in pemphigus. We would like to report this case due to the unusual coexistence of thermal burns triggering pemphigus and KP occurring in the same patient.

Prevalence of trauma exposure and PTSD symptoms among the Icelandic population: gender and regional differences.

The primary aim of this cross-sectional study was to provide descriptive data about the lifetime prevalence of trauma exposure with a particular focus on sexual violence and natural disasters and to assess the prevalence of symptoms of post-traumatic stress disorder (PTSD) in the Icelandic population. In addition, the aim was to investigate whether PTSD symptoms, trauma types and prevalence differed by gender and geographical location. A representative sample of the population between the ages of 18 and 80 years was randomly selected from the Icelandic National Registrar. The study included a total of 1766 participants consisting of 930 (52.7%) women and 836 (47.3%) men, with an overall mean age of 49.9 years (standard deviation 16.1). Participants were contacted by phone and asked questions from the Lifetime Events Checklist (LEC-5) to assess lifetime exposure to traumatic events. Individuals who had experienced traumatic events completed the PTSD Checklist for DSM-5 (PCL-5) to assess PTSD symptoms. Exposure to trauma is common among the Icelandic population, with 84.3% of the participants experiencing at least one kind of trauma. Of those exposed to trauma, 10.5% fulfilled criteria indicating a higher risk of PTSD. The prevalence of sexual violence and other unwanted sexual experiences was relatively high (16.2% and 24.4%, respectively) compared with other national studies. Women were almost four times more likely than men to have been exposed to sexual violence (24.9% vs 6.4%), and were more likely to have been exposed to other unwanted sexual experience (35.1% vs 12.4%, respectively). Exposure to natural disasters is frequent but with great geographical variation. This study highlights the high prevalence of trauma in Iceland, revealing significant gender disparities in sexual violence and geographical variations in natural disaster exposure.

Influence of betrayal trauma on obsessive-compulsive personality pathology.

Obsessive-compulsive personality disorder (OCPD) is among the most common forms of personality pathology. Research suggests that among the risk factors for OCPD pathology is trauma, although it is unclear which kinds of trauma are most influential. Of particular relevance may be trauma high in interpersonal betrayal, which research suggests has a unique association with many different forms of personality pathology. However, this has not yet been examined for OCPD specifically. In this study, we examined the differential associations between trauma with varying levels of betrayal and OCPD pathology in a sample of women and men recruited online (N = 300) using a Bayesian approach to structural equation modeling. Results suggest that although general interpersonal trauma was associated with OCPD across the sample, interpersonal trauma high in betrayal was uniquely associated with OCPD for men. These findings have implications for future research on the influence of trauma and personality pathology as well as for the treatment of OCPD specifically. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Multi-Detector Computed Tomography Angiographic Evaluation of Extremity Vascular Trauma: Case Series

Objective: The purpose of this article is to review the multidetector computed tomography (MDCT) angiography within the evaluation of extremity trauma. Trauma could be a great public health dilemma in developing and developed countries and regularly involves teenagers. Among different kinds of trauma, vascular injuries of the extremities need special consideration because they’ll be threatening to limb and life. Vascular injury going to exsanguination and hemorrhagic shock is second to central nervous system injury; thus, imaging diagnosis is crucial for the trauma victim as early as possible from admission to the hospital. Although the speed of successful management of those injuries has been increased because of proper pre hospitalization, early referral of patients to specialized trauma centers, and proper surgical interventions, these injuries remain a challenging problem, especially in developing countries.
 Conclusion: With the rising trend of road traffic accidents and violence, vascular injuries have become a significant contributor of limb loss, with increased morbidity and mortality. MDCT Angiography has become the most non-invasive diagnostic imaging vascular triage tool applicable to all or any varieties of extremity trauma. Axial sections, multiplanar reconstructions and 3D volume-rendered images should aid within the detection and improve the interpretation of such vascular injuries, osseous and soft-tissue injuries which could be of immense help to the clinician planning surgical procedures.

Effect of ascorbic acid on collagen and some inflammatory mediators in rats

Musculoskeletal injuries as a kind of trauma that the human body is exposed to, adversely affect the quality of life and workforce of individuals due to restriction of movement function. This study aimed to evaluate the effects of dose-dependent ascorbic acid (AA) administration on the repair process after gastrocnemius muscle injury in rats. In this study, 5-month-old 66 male Wistar Albino rats were used and rats were randomly divided into 6 groups of 11 each [control, muscle injury, healthy (with 5 mg/10 mg/kg/day AA-treated group), injury (with 5 mg/10 mg/kg/day AA-treated group)]. A linear incision was made in the gastrocnemius muscle of thirty-three animals included in the muscle injury groups. AA (5-10 mg/kg/day) was administered to the four groups intraperitoneally just after surgery once a day. Animals were sacrificed twenty-one days later. Blood and tissue samples were used for cytokine, collagen, and histological measurements. It was found that a dose of 5 mg/kg/day AA administration reduced serum IL-6 and muscle tissue TNF-α levels, and increased liver tissue IL-10 levels. Muscle tissue collagen levels were not statistically different between the groups in parallel with our histological results. In our study, it was demonstrated that vitamin C has effects on inflammatory mediators during muscle tissue repair to explain the mechanism detailed molecular analyzes are needed.

The impact lingers well beyond childhood: Child sexual abuse, trauma symptoms, and income for adult survivors

Child sexual abuse (CSA) is a traumatic experience, and this kind of trauma has far-reaching effects. While it is known that CSA affects mental, emotional, and physical well-being, its relationship to income is still being explored. Objective: The current study examined the relationships between child sexual abuse, trauma symptoms, education, and income levels in adult survivors of CSA (n = 260). The participants in this study were gathered anonymously online by posting links to the study on adult survivor of CSA support group websites. While the participants’ incomes ranged from about $20,000 to over $100,000, the mean household income was between $40,000 and $59,000. There were no significant differences in income by gender or ethnicity. Regressions suggest that while education and marital status were of course significantly related to income, both frequency and severity of abuse were also significantly connected with income (all p's <0.05). Furthermore, trauma symptoms of anxiety, depression, sleep problems, and dissociation were significantly linked with income (all p's <0.05). Path analysis showed that the effects of trauma on income were mediated through education levels. However, trauma symptoms still negatively affected income.

Naked men on the run, regression to childhood: cultural figures of the trauma during the First World War

AbstractAlthough there is a wide-ranging historiography dealing with psychoneurosis, various manifestations of psychic suffering widespread among traumatised soldiers during the Great War have received less attention. This essay, based on an analysis of soldiers' clinical files in Italian psychiatric hospitals, draws out these phenomena. The main forms assumed by this kind of trauma are three: soldiers who strip off their uniform and wander around naked; a sort of regression to childhood; and a particular type of hysteria. The essay stresses how existingstereotypes about women were adapted to form a new way of describing masculinity in crisis, and the new political subject: the masses. Too many emotions, too many nerves, define the affected men: they are subjects deprived of personality, and their predicament highlights the transition from soldier-hero to mass-soldier.

Dynamics of Peripheral Blood Immune Cells during the Perioperative Period after Digestive System Resections: A Systematic Analysis of the Literature.

An operation in itself is a kind of trauma and may lead to immunosuppression followed by a bounce back. Not many studies exist that describe dynamics of the distribution of peripheral blood (PB) immune cells during the perioperative period. Considering this scarcity, we aggregated the data on the dynamics of immune cells in patients with digestive system resections during the perioperative period and the relationship with short- and long-term prognoses. By the systematic retrieval of documents, we collected perioperative period data on white blood cells (WBC), lymphocytes, neutrophil-lymphocyte ratio (NLR), CD4+ T cells, CD8+ T cells, helper T cells (Th), B cells, natural killer cells (NK), dendritic cells (DCs), regulatory T cells (Tregs), regulatory B cells (Bregs), and Myeloid derived suppressor cells (MDSC). The frequency and distribution of these immune cells and the relationship with the patient's prognosis were summarized. A total of 1916 patients' data were included. Compared with before surgery, WBC, lymphocytes, CD4+ cells, CD8+ T cells, MDSC, and NK cells decreased after surgery, and then returned to preoperative levels. After operation DCs increased, then gradually recovered to the preoperative level. No significant changes were found in B cell levels during the perioperative period. Compared with the preoperative time-point, Tregs and Bregs both increased postoperatively. Only high levels of the preoperative and/or postoperative NLR were found to be related to the patient's prognosis. In summary, the surgery itself can cause changes in peripheral blood immune cells, which might change the immunogenicity. Therefore, the immunosuppression caused by the surgical trauma should be minimized. In oncological patients this might even influence long-term results.

A 3-year retrospective study of 866 children and adolescent outpatients followed in the Nice Pediatric Psychotrauma Center created after the 2016 mass terror attack.

The mass terrorist attack in Nice, France, in July 2016 caused deaths and injuries in a local population, including children and adolescents. The Nice Pediatric Psychotrauma Center (NPPC) was opened to provide mental health care to the pediatric population (0-18 years) who experienced traumatic events. This study describes the specificity of the care pathway for young trauma victims, with an explanation of how the NPPC works during the first three years. In this retrospective study, we conducted quantitative and qualitative data collection about new and follow-up consultations, primary and comorbid diagnoses, and the kind of trauma (terrorist attack versus other kinds of trauma). Ethics approval was obtained from the local Ethics committee. 866 children and adolescents were followed in the NPPC. We found a high rate of Post-Traumatic Stress Disorder (PTSD; 71%) in this population with a high rate of comorbidities (67%), mainly sleep disorders (34.7%) and mood and anxiety disorders (16.2%). A high number of children and adolescents impacted by the terrorist attack required follow-up consultations after exposure to the mass terrorist attack, the first care-seeking requests continued to occur three years later, although at a slower rate than in the first and second years. New consultations for other kinds of trauma were observed over time. This study supports previous findings on the significant impact of mass trauma in the pediatric population showing even a higher level of PTSD and a high rate of comorbidities. This may be explained by the brutality of the traumatic event, particularly for this age group. The findings of this study have implications for early interventions and long-term care for children and adolescents to prevent the development of chronic PTSD into adulthood.

Post-traumatic stress disorder and associated factors among people who experienced traumatic events in Dessie town, Ethiopia, 2022: A community based study

Posttraumatic stress disorder (PTSD) may develop as a serious long-term consequence of traumatic experiences, even many years after trauma exposure. Dessie town residents have experienced prolonged armed conflict due to inter-communal conflict in 2021. Those people are exposed to different kinds of trauma, and violence, making them more prone to psychological disorders. Despite the highest number of people affected due to conflict and its negative impact on mental health, post-traumatic stress disorders among people are overlooked in Ethiopia. This study aimed to assess the prevalence and associated factors of post-traumatic stress disorder among people who experienced traumatic events in Dessie town, Ethiopia, 2022. Community based cross-sectional study was conducted on June 8-July 7, 2022, by using a multi-stage cluster sampling with a total sample of 785. Pretested, structured questionnaires and face-to-face interviews were used for data collection. PTSD was assessed by the Post-traumatic stress disorder Checklist for DSM-5 (PCL-5). Data was entered using Epi-data version 3.1 and, then exported to SPSS version 26 for analysis. The association between outcome and independent variables was analyzed with bi-variable and multivariable logistic regression. P-values less than 0.05 was considered statistically significant. The prevalence of PTSD among Dessie town residents was found to be 19.4% (95% CI, 16.7, 22.0). In multivariable analysis, being females (AOR = 1.63, 95% CI 1.10-2.44), previous history of mental illness (AOR = 3.14, 95% CI 1.14-7.06) depressive symptoms (AOR = 3.12, 95% CI 1.92-5.07), witnessing a serious physical injury of a family member or friend (AOR = 2.82, 95% CI 1.18-6.70) and high perceived life threats (AOR = 5.73, 95% CI 3.05-10.78) were found to be significant predictors of PTSD. The prevalence of PTSD among Dessie town residents was found to be huge. Being female, having a previous history of mental illness, depressive symptoms, witnessing a serious physical injury of a family member or friend, and high perceived life threats were variables that are independent predictors of PSTD. People who have experienced such a severe traumatic event require psychosocial support to aid in their recovery from the terrible experiences.

Economic crisis and trauma journalism: Assessing the emotional toll of reporting in crisis-ridden countries

AbstractThis article discusses the relationship between the post-2008 global economic crisis and trauma journalism through a quantitative study of reporters covering austerity’s everyday manifestations and examines the effects on the media professionals involved. The findings indicate that journalists who cover economic crisis-related incidents suffer specific symptoms of trauma. As such, the study re-conceptualizes the economic crisis as primarily affective for media workers, it establishes a direct correlation between the economic crisis and emotional trauma, and provides an insight into the kind of trauma that stems from covering austerity and its impact on society. A regression analysis of symptoms indicates trauma journalism as an emerging field of research into the economic crisis.

ГОЛОД 1921 -1922 ГГ. В КАЗАХСТАНЕ, КАК СОЦИАЛЬНО-КУЛЬТУРНАЯ ТРАВМА

This article was written within the framework of the project "Famine in Kazakhstan in 1921-1922 and its consequences" and aims to highlight the problem of determining the real causes of hunger and its consequences for the Kazakh people. The development of an objective and balanced assessment of complex and contradictory events of Soviet history has been an urgent task of Kazakh historians over the past few decades The study of the history of the famine of 1921-1922 is in line with the current problems of Kazakh historiography of the Soviet period. However, the question of the reasons that became the basis of this terrible and tragic phenomenon is of paramount importance. As a working hypothesis, the authors put forward the position that the famine of the first years of Soviet power was to a certain extent used by the Bolsheviks for their political purposes.Food policy served as a means of pacifying the rural population and Kazakhs in thefirst place, who for the most part did not understand and did not accept the ideology of the Bolshevik regime. As an evidence base, the authors analyzed such phenomena of the emerging humanitarian catastrophe –food dictatorship, the policy of "war communism", the main link of which was the Military-coercive measures of the seizure of products "clean", did not leave even a minimum for the basic needs of the population. The food crisis was also joined by weather conditions –drought and jute in 1921, which led to the death of the few livestock left after the prodrazverstka. The article examines the activities of armed food detachments engaged in tax collection, endowed with enormous powers, which they exceeded with impunity: they arrested and even shot without trial people who stood up to protect their families.The consequences of the famine had an important socio-cultural significance. The authors put forward the position that hunger became a kind of trauma that had far-reaching socio-cultural consequences for the self-consciousness of the Kazakh people

Estimation of Injuries in a Population-based Study by Stratified Cluster Sampling and Network Scale-up Methods

Introduction: Today, one of the most important causes of morbidity and mortality among people all across the world is Injury. Injuries pose an important challenge for the health system and account for 28% of the deaths per day in Iran. Iran is in the 5th place for road traffic death rates globally.&#x0D; Objective: This was a cross sectional study aimed to estimate annual incidence rates of injury in individuals above 15 in Kashan, Iran.&#x0D; Methods: In this population-based cross-sectional study, people above 15 years in households residing in Kashan during 2018-2019 were studied The sample had a twofold design, Stratified Cluster Sampling method and network Scale-up method. Data analysis was performed using SPSS 22 (Chi-square and T-test and Logistic regression analysis) and Stata 14 software.&#x0D; Results: This study describes the study setting, sampling, data collection and management, quality control and assurance, and the statistical analysis. In this study, the annual incidence rate from all kinds of trauma was estimated at 70.61(62.60-78.70) per 1000 person-years, and the death caused by injury was 4.63(34.32-56.12) per 1000 person-years. In addition, in network scale-up method incidence rate of all kinds of trauma was 57.1 and the death caused by trauma was 3.47 per 1000 person-years.&#x0D; Conclusion: population-based studies were used to evaluate injuries and outcomes of trauma, so that managers realize where attention is needed regarding preventive programs in this city. Using indirect sampling techniques can be cost-effective and time-consuming, and can provide us with the information urgently needed.

Suicide Risk and Association With the Different Trauma During the COVID-19 Pandemic Period: A Cross-Sectional Study on Adolescent With Different Learning Stage in Chongqing, China.

This study aimed to examine the current suicidal risk and whether the suicidal risk was associated with a wide range of trauma. The self-administered online questionnaire was adopted to collect suicide risk (SR) such as suicidal ideation, self-harm, suicide attempts, and different trauma information of the adolescents by cluster sampling in Chongqing, China. Multivariable linear regression was presented to assess the association between different risks of trauma and SR scores. Approximately 14.7% of adolescents enrolled reported suicide ideation and more than 10% of adolescents have experienced one kind of trauma during the Coronavirus disease 2019 (COVID-19) pandemic period. After adjusting for confounding variables, adolescents who suffered family hurt had a higher risk score of SR (beta coefficients (β) = 0.289, 95% confidence interval (CI) = 0.115–0.463). A positive association was found among participants from junior and senior school (β = 0.415, 95% CI = 0.152, 0.768), and the SR score was positively associated with sexism among participants from the university/college (β = 0.238, 95% CI = 0.042, 0.434). The most potentially obvious trauma that contributed to SR in junior and senior school adolescents might be cyberbullying. Family neglect or abuse might be a detrimental factor in SR for adolescents whether those in junior school or those in university school in China. More interventions, like education related to cyberbullying and family abuse, should be prioritized to reduce the risk of suicide.

Factors associated with posttraumatic growth among North Korean defectors in South Korea

Refugees experience various kinds of trauma during the migration process, which can cause psychiatric problems such as posttraumatic stress disorder. However, in the process of overcoming traumatic experiences, they may also experience posttraumatic growth (PTG). This study examined the level of PTG and its associated factors among North Korean defectors, including posttraumatic stress symptoms (PTSS). In total, 212 North Korean defectors completed self-report questionnaires measuring PTG (PTG inventory), PTSS (Posttraumatic Stress Disorder Checklist, PCL-5), quality of life (WHOQOL-BREF), and various sociodemographic variables. Participants completed the survey online, from July 27 to August 4, 2020. Participants reported a moderate level of PTG scores (51.7 ± 15.4, range 0–80). To determine the impact of PTSS on PTG among North Korean defectors, we conducted a hierarchical multiple regression analysis. In the final model, several sociodemographic factors (years in South Korea, education in North Korea, religion, and employment status), overall quality of life (β = 0.321, p < 0.001), and PTSS (β = 0.162, p = 0.035) were positively associated with PTG, whereas living with family (β = − 0.1261, p = 0.040) and loneliness (β = − 0.401, p < 0.001) were negatively associated with PTG, accounting for 36.6% of the variance in PTG scores (p < 0.001). This is the first large-scale study describing the level of PTG and its associated factors among North Korean defectors residing in South Korea. Further, our study provides suggestions for future research in this area, and interventions for improving PTG among this group.

Treatment Decisions in Patients With Potentially Nonsurvivable Burn Injury in Australia and New Zealand: A Registry-Based Study.

Whilst burn-related mortality is rare in high-income countries, there are unique features related to prognostication that make examination of decision-making practices important to explore. Compared to other kinds of trauma, burn patients (even those with nonsurvivable injuries) may be relatively stable after injury initially. Complications or patient comorbidity may make it clear later in the clinical trajectory that ongoing treatment is futile. Burn care clinicians are therefore required to make decisions regarding the withholding or withdrawal of treatment in patients with potentially nonsurvivable burn injury. There is yet to be a comprehensive investigation of treatment decision practices following burn injury in Australia and New Zealand. Data for patients admitted to specialist burn services between July 2009 and June 2020 were obtained from the Burns Registry of Australia and New Zealand. Patients were grouped according to treatment decision: palliative management, active treatment withdrawn, and active treatment until death. Predictors of treatment initiation and withholding or withdrawing treatment within 24 hours were assessed using multilevel mixed-effects logistic regression. Descriptive comparisons between treatment groups were made. Of the 32,186 patients meeting study inclusion criteria, 327 (1.0%) died prior to discharge. Fifty-six patients were treated initially with palliative intent and 227 patients had active treatment initiated and later withdrawn. Increasing age and burn size reduced the odds of having active treatment initiated. We demonstrate differences in demographic and injury severity characteristics as well as end of life decision-making timing between different treatment pathways pursued for patients who die in-hospital. Our next step into the decision-making process is to gain a greater understanding of the clinician's perspective (eg, through surveys and/or interviews).