Factors affecting mortality in burns: a single center study
DOI:
https://doi.org/10.18203/2349-2902.isj20205667Keywords:
Burns, Factors, Treatment, Complications, Mortality, OutcomesAbstract
Background: Burns injury continues to be the greatest challenge to the trauma surgeon. A multitude of factors determine the mortality in burns patients. The present study aims at identifying those factors which have a significant impact on mortality in burns patients.
Methods: A total 80 patients presenting with burns injury were studied prospectively. Various factors which included age, sex, aetiology, mode of injury, total body surface area which is burnt (BSA), duration of stay, time interval up to admission, pregnant state, inhalation injury, systemic complications, wound complications, and psychological impact were studied.
Results: The mean age was 24.07 years. 59 were females, 21 were males. 19 (23.75%) cases were suicidal in aetiology whereas the remaining 61(76.25%) were accidental. Flame injury was the most common mode of injury in 65 patients (81.25%). The mean BSA in the study was 53.5% whereas the mean BSA in those patients who expired was 71.4%. Mean duration of stay in hospital was 6.55 days whereas mean time interval between burns injury and admission to hospital was 101.33 minutes. All 12 pregnant women had spontaneous miscarriages with a mortality in 11 patients. Inhalation injury was seen in 49 patients (61%) with mortality of 42 (83.7%) patients. Systemic complications seen in 60 patients mortality and BSA was high in patients who had infection. 31 patients in the study had severe depression with a mortality of 91.32%. 50 out of the 80 patients studied expired.
Conclusions: Increased age, BSA, mode of injury, presence of inhalation injury, systemic complication, pregnant state, wound infection and depression had a significant impact on the mortality of burns patients.
References
Smith DL, Cairns BA, Ramadan F. Effect of inhalation injury, burn size, and age on mortality: a study of 1447 consecutive burn patients. The Journal of Trauma. 1994;37(4):655-659.
Güldoğan CE, Kendirci M, Gündoğdu E, Yastı AÇ. Analysis of factors associated with mortality in major burn patients. Turk J Surg. 2018;35(3):155-164.
Abu-Sittah GS, Chahine FM, Janom H. Management of burns in the elderly. Ann Burns Fire Disasters. 2016 ;29(4):249-245.
Ingrid S, Mats F, Zoltan B, Folke S. Mortality After Thermal Injury: No Sex-Related Difference. The Journal of Trauma: Injury, Infection, and Critical Care. 2011;70(4):959-64.
O'Keefe GE, Hunt JL, Purdue GF. An evaluation of risk factors for mortality after burn trauma and the identification of gender-dependent differences in outcomes. J Am Coll Surg. 2001;192(2):153-60.
Muller MJ, Pegg SP, Rule MR. Determinants of death following burn injury. Br J Surg. 2001;88(4):583-7.
Lari AR, Joghataei MT, Adli YR, Zadeh YA, Alaghehbandan R. Epidemiology of Suicide by Burns in the Province of Isfahan, Iran. Journal of Burn Care & Research. 2007;28(2):307-11.
Ahuja RB, Bhattacharya S. Burns in the developing world and burn disasters. BMJ. 2004;329(7463):447-9.
Jie X, Baoren C. Mortality rates among 5321 patients with burns admitted to a burn unit in China: 1980-1998. Burns. 2003;29(3):239-45.
da Silva PN, Amarante J, Costa-Ferreira A, Silva A, Reis J. Burn patients in Portugal: analysis of 14,797 cases during 1993-1999. Burns. 2003;29(3):265-9.
Groohi B, Alaghehbandan R, Lari AR. Analysis of 1089 burn patients in province of Kurdistan, Iran. Burns. 2002;28(6):569-74.
Deitch EA, Rightmire DA, Clothier J, Blass N. Management of burns in pregnant women. Surg Gynecol Obstet. 1985;161(1):1-4.
Benmeir P, Sagi A, Greber B, Bibi C, Hauben D, Rosenberg L et al. Burns during pregnancy: our experience. Burns Incl Therm Inj. 1988;14(3):233-6.
Chang CJ, Yang JY. Major burns in pregnancy. Changgeng Yi Xue Za Zhi. 1996;19(2):154-9.
Rita G, Leticia S-Q, Sonia PD. Prevalence and prognostic impact of inhalation injury among burn patients: A systematic review and meta-analysis. Journal of Trauma and Acute Care Surgery. 2020;88(2):330-44.
Macedo JL, Santos JB. Predictive factors of mortality in burn patients. Rev Inst Med Trop Sao Paulo. 2007;49(6):365-70.
Setoodehzadeh F, Ansari H, Zarei T, Surodi Z, Arbabi Z, Khammarnia M. Factors affecting mortality in burn patients in the poorest region of Iran; a case control study. Int J Burns Trauma. 2019;9(3):66-72.
Kim Y, Kym D, Hur J, Yoon J, Yim H, Cho YS, Chun W. Does inhalation injury predict mortality in burns patients or require redefinition? PLoS One. 2017;12(9):e0185195.
El-Helbawy RH, Ghareeb FM. Inhalation injury as a prognostic factor for mortality in burn patients. Ann Burns Fire Disasters. 2011;24(2):82-8.
Palmieri TL. Inhalation injury: research progress and needs. J Burn Care Res. 2007;28(4):549-54.
Knowlin L, Stanford L, Moore D, Cairns B, Charles A. The measured effect magnitude of co-morbidities on burn injury mortality. Burns. 2016;42:1433-8.
Aggarwal A, Chittoria RK, Chavan VK, Gupta S, Reddy CL, Mohan PB et al. The role of comorbidities in the prognosis of thermal burns. Indian J Burns. 2019;27:16-9.
Nielson CB, Duethman NC, Howard JM, Moncure M, Wood JG. Burns: Pathophysiology of Systemic Complications and Current Management. J Burn Care Res. 2017;38(1):e469-e481.
Milione VR, Kanat IO. Burns: a review of the pathophysiology, treatment, and complications of thermal injury. J Foot Surg. 1985;24(5):373-82.
Hall C, Hardin C, Corkins CJ, Jiwani AZ, Fletcher J, Carlsson A et al. Pathophysiologic Mechanisms and Current Treatments for Cutaneous Sequelae of Burn Wounds. Compr Physiol. 2017;8(1):371-405.
Güldoğan CE, Kendirci M, Tikici D, Gündoğdu E, Yastı AC. Clinical infection in burn patients and its consequences. Ulusal Travma ve Acil Cerrahi Dergisi. 2017;23(6):466-471.
Temiz A, Albayrak A, Peksöz R, Dışcı E, Korkut E, Tanrıkulu Y, et al. Factors affecting the mortality at patients with burns:Single centre results. Ulus Travma Acil Cerrahi Derg. 2020;26:777-783.
Hudson A, Al Youha S, Samargandi OA, Paletz J. Pre-existing psychiatric disorder in the burn patient is associated with worse outcomes. Burns. 2017;43(5):973-82.
