• Yu Wang, Hong-Tai Tang, Zhao-Fan Xia, Shi-Hui Zhu, Bing Ma, Wei Wei, Yu Sun, and Kai-Yang Lv.
• Department of Burn Surgery, Changhai Hospital, the Second Military Medical University, 174# Changhai Road, Shanghai 200433, China.
• Burns. 2010 Feb 1;36(1):57-64.

ObjectiveTo identify treatment-related factors associated with mortality in massively burned adult patients.MethodsThis retrospective cohort study examined survival outcomes at a burn unit of 54 beds and 10 burn ICU beds, totaling 900 admissions per year. The cases of 102 adult patients, admitted consecutively from January 1993 to October 2007, with massive burns (burn area>70% of the total body surface area, TBSA) were studied. Relevant variables were recorded from the initial injury and throughout the hospital course. Survival analysis, based on univariate and stepwise multivariate Cox proportional hazards regression, was performed to determine which variables predicted mortality.ResultsThe overall mortality rate was 30.4%. Burn size, severe inhalation injury, full-thickness burns, serum creatinine levels, inotropic support, platelet counts<20,000 per mm3, sepsis and ventilator dependency were significantly associated with mortality as determined by univariate analysis. Only sepsis, ventilator dependency and platelet counts were significant independent predictors of mortality as determined by multivariate analysis.ConclusionsSepsis, ventilator dependence (indicating severe respiratory complications), and low platelet counts (indicating thrombocytopenia) are associated with increased mortality risk in adult patients with massive burns. Methods should be sought to ameliorate these complications during treatment in burn-care units.Copyright (c) 2009 Elsevier Ltd and ISBI. All rights reserved.

26 keywords...

hide…