• James Nunn, Jack Rasmussen, Nelofar Kureshi, Robert S Green, and Mete Erdogan.
• Department of Emergency Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada. Electronic address: james.nunn@dal.ca.
• Burns. 2024 Dec 26; 51 (2): 107363107363.

IntroductionThe combination of burns and non-thermal trauma may have a synergistic effect on mortality. Our objective was to determine if burn patients with concomitant trauma are at increased risk of mortality in both the prehospital and in-hospital settings.MethodsData were collected from a population-based provincial trauma registry (2001-2019). Characteristics and outcomes of patients with trauma/burns were compared to isolated burn patients using t-tests, chi-square analysis and Fisher's exact tests. Risk ratios (RRs) were calculated to evaluate the impact of concomitant trauma on mortality, stratified by % total body surface area (TBSA) and injury severity score (ISS). Firth's penalized maximum likelihood estimation (PMLE) approach was used to fit multivariable logistic regression models to the outcomes of prehospital mortality and in-hospital mortality.ResultsOf 436 burn patients, 29.8 % (130/436) had combined trauma/burns. Prehospital mortality in the trauma/burns group was 57.7 % (75/130) versus 43.1 % (132/306) in isolated burn patients. Prehospital mortality risk was highest in trauma/burn patients with % TBSA ≥ 70 (RR 3.87, 95 % CI 2.99-4.99) or ISS ≥ 25 (RR 2.49, 95 % CI 1.84-3.36). Concomitant trauma was associated with increased odds of prehospital mortality (OR 2.42, 95 % CI 1.27-4.69), but had no impact on in-hospital mortality.ConclusionsPrehospital mortality was increased in patients with combined burns and trauma.Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.

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