Journal of burn care & research : official publication of the American Burn Association
-
Amputations following a burn injury, although infrequent, may affect community reintegration and create a barrier to returning to work. The objective of this study was to compare patient and injury characteristics, quality of life, and employment status for those with and without amputation using a national longitudinal database of people with burn injuries. In this retrospective review of prospectively collected data, group differences were examined using descriptive statistics. ⋯ Amputation was a statistically significant predictor of SF-12 scores at 6 months for both PCS (β = .10, P = .003) and MCS (β = -.07, P = .04) scores. Amputations are relatively rare following burn injury and are more often associated with electrical and contact injuries. Whereas, people with amputations were less likely to be employed at 12 months postburn, those who were employed before the injury were more likely to return to work regardless of amputation status.
-
Observational Study
Evaluation of Procalcitonin Accuracy for the Distinction Between Gram-Negative and Gram-Positive Bacterial Sepsis in Burn Patients.
Sepsis is the main cause of death in burns. Early institution of antimicrobial therapy is crucial to optimize outcomes but superfluous therapy increases adverse events, microbial resistance, and costs. Blood cultures are the gold standard for diagnosis but can take 48 to 72 hours. ⋯ Most elevated levels were related to nonfermentative Gram-negative bacteria and by Klebsiella pneumoniae and other Enterobacteriaceae. PCT levels were significantly higher in burn patients with Gram-negative sepsis comparing to patients with Gram-positive sepsis and controls. The determination of PCT levels may help the choice of empirical antimicrobial therapy while microbiological culture results are not available, despite not fully ensuring the desirable degree of precision.