• Robert Kraft, David N Herndon, Celeste C Finnerty, Shahriar Shahrokhi, and Marc G Jeschke.
• *Shriners Hospitals for Children †Department of Surgery, University of Texas Medical Branch, Galveston, TX ‡Department of Surgery, Division of Plastic Surgery and Immunology, University of Toronto, Ontario, Canada §Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; and ¶Sunnybrook Research Institute, Toronto, Canada.
• Ann. Surg. 2014 Feb 1; 259 (2): 381-7.

ObjectiveTo examine the incidence of single or multiple organ failure postburn and its resultant clinical outcomes during acute hospitalization.BackgroundPatient outcomes are inherently dependent on intact organ function; however, burn injury affects the structure and function of almost every organ, but especially lung, liver, kidney, and heart. Therefore, single-organ failure and/or multiorgan failure (MOF) are thought to contribute significantly to postburn morbidity and mortality, but to date no large trial examining the effects of MOF on postburn outcomes exists.MethodsIncidence of MOF was monitored in 821 pediatric burn patients during acute hospitalization. Patients were divided into groups on the basis of the incidence of single-organ-specific failure, MOF, and non-MOF. The DENVER2 score was used to assess organ-specific scores for lung, liver, kidney, and heart. The patient's demographics, injury characteristics, and outcome parameters were recorded.ResultsRespiratory failure has the highest incidence in the early phase of postburn injury and decreases starting 5 days postburn. Cardiac failure was noted to have the highest incidence throughout hospital stay. Incidence of hepatic failure increases with the hospital length of stay and is associated with a high mortality during the late phase of the acute hospital stay. Renal failure has an unexpectedly low incidence but is associated with a high mortality during the first 3 weeks postburn injury. Three or more organ failure is associated with very high mortality.ConclusionsThis is the first large study in burn patients to determine the incidence of organ-specific failure and outcome. The results of this study confirmed the expected chronologic incidence of organ-specific failure and yield the long-term mortality from liver and renal failure.

30 keywords...

hide…