Long-term sequelae of low-voltage electrical injury

Abstract

In North America, electrical injuries result in approximately 20,000 emergency department visits every year. They are the most common form of occupationally related burn injury, and the fifth leading cause of occupational fatality in the United States. The purpose of this study was to determine the long-term sequelae of low-voltage electrical burn injuries. A retrospective hospital chart review was conducted among electrical burn patients, admitted to a regional adult burn centre or a rehabilitation hospital between January 1, 2002 and December 31, 2003, to find new symptoms documented at follow-up visits. Telephone interviews were conducted to a random sample of these patients to document symptoms that had occurred since the injury. Thirty-eight of 39 electrical patient charts were reviewed, one was excluded because of a lack of follow-up notes. There were 35 (92%) men and three (8%) women with a mean age (+/-SD) of 45.4 +/- 13.4 years, and 8.9 +/- 10.5% total body surface area. The majority (97.4%) were work-related injuries, most of them (58%) because of low-voltage (<1000 V), most frequently electrical flash burns (55%). Neurological (81.6%) and psychological (71%) symptoms were the most common sequelae. The most frequent neurological symptoms were numbness (42%), weakness (32%), memory problems (32%), paresthesia (24%), and chronic pain (24%). The most common psychological symptoms were anxiety (50%), nightmares (45%), insomnia (37%), and flashbacks (37%) of the event. There were more patients with numbness (19 vs 59%) and nightmares (25 vs 59%) in the low-voltage group. Patients with more neurological symptoms also have more psychological symptoms. Eleven patients interviewed, reported a high incidence of neurological (82%), general (54%), and psychological (54%) symptoms, which occurred at 5.3 months, 1.7 months, and 1.5 months, respectively, after the electrical injury (EI). Electrical injured patients experience many physical and psychological sequelae after their injuries. Many of these symptoms are nonspecific, and they often do not appear until several months after the injury. Low-voltage EI produced more frequent long-term sequelae than high-voltage injuries. Frequent patient monitoring and prompt intervention of progressive changes after EI may improve the physical, psychological, and psychosocial recovery of these patients.