• Burns · Aug 2018

    Optimizing mass casualty burns intensive care organization and treatment using evidence-based outcome predictors.

    • Huang-Kai Kao, Loh Charles Yuen Yung CYY Department of Plastic and Reconstructive Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiw, Hao-Wei Kou, Kuo-Chin Kao, Han-Chung Hu, Chia-Ming Chang, Chia-Hui Lee, and Hsiang-Hao Hsu.
    • Department of Plastic and Reconstructive Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan. Electronic address: kai3488@gmail.com.
    • Burns. 2018 Aug 1; 44 (5): 1077-1082.

    BackgroundMajority of current research focuses on pre-hospital care in mass casualty incidents (MCI) whereas this study is the first to examine multifactorial aspects of intensive care unit (ICU) resource management during a surge in massive burn injury (MBI) patients whilst identifying key outcome predictors that resulted in successful disaster managements.MethodsBoth critical care, surgical parameters and cost-effectiveness are investigated in patients admitted with severe burns resulting from the explosion. A fully integrated trauma response and expansion of critical care resources in Linkou Chang Gung Memorial Hospital (CGMH) in this incident is analyzed.Results52 burn patients were treated in CGMH and 27 patients (51.9%) had TBSA greater than 45% with the mean TBSA of 44.6±20.3%. ICU based management of MBI including early debridement and resource strategizing. The overall mortality rate was 2/52 (3.85%). Patients had an average of 14.8days on mechanical ventilation and 43days as an inpatient in total. Operative treatment wise, 44.2% of patients received escharotomies and each patient received an average of 2 skin grafting procedures. The initial TBSA was a significant predictor for burn wound infection (OR 1.107, 95% CI 1.023-1.298; p=0.011). Each patient cost an average of USD 1035 per TBSA% with an average total cost of USD 50415.ConclusionWith ever increasing chances of terrorist activity in urban areas, hospitals can hopefully increase their preparedness using outcome-predictors presented in this study.Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

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