Burns : journal of the International Society for Burn Injuries
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Acute kidney injury (AKI) is common in major burn injuries and associated with increased mortality. With advances in surgical and critical care it is unclear if mortality in this population remains this high. This study aims to describe incidence and outcomes of patients admitted to intensive care (ICU) with a burn injury who develop AKI. We additionally sought to determine risk factors for developing AKI. ⋯ AKI is common in patients with a major burn injury. However, mortality is lower than described in the literature, particularly for those who required renal replacement therapy.
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Large burns are associated with a dramatic increase in metabolic demand, and adequate nutrition is vital to prevent poor wound healing and septic complications. However, enteral nutrition (EN) support is frequently withheld perioperatively, risking nutritional deficits. We retrospectively examined the safety and feasibility of continuing EN during surgery in patients with an established airway, and estimated the impact of perioperative fasting on overall caloric intake. ⋯ Continuing EN intraoperatively in patients with an established airway appears to be a safe and efficacious way to meet patients' nutritional needs, including when feeding is delivered via a gastric route. This is particularly important given that placement of nasojejunal feeding tubes can be difficult, particularly in resource-poor settings where endoscopic or fluoroscopic-guided placement may not be practical.
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The current study examined the utility of Ajzen's Theory of Planned Behavior (TPB) in explaining adolescents' intentions to engage in fire-risk behaviors (e.g., using accelerants to start a fire), while controlling for relevant background variables. A total of 222 youth (M age=15.23years; 69% female) were recruited from public schools in rural and urban areas in the United States. Participants completed questionnaires that assessed fire and burn safety knowledge, TPB components, adolescent psychopathology, parental monitoring, and adolescent risk-taking. ⋯ These results suggest that youth who had positive attitudes (e.g., engaging in fire-risk behaviors is fun) towards fire-risk behaviors and who believed significant others would approve of them engaging in fire-risk behaviors tended to have more intentions to engage in these behaviors. The TPB was able to account for the variance in adolescents' intentions over and above several control/background variables (e.g., SES, gender), with the exception of rebellious behavior (β=.25, p<0.05). Results from this study can be used to inform the design of effective and targeted fire and burn prevention programs aimed specifically at adolescents.
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Substance use is disproportionately high in burn patients and associated with adverse outcomes. Screening methods for substance use disorders may help predict or avoid adverse outcomes. The University of Utah Burn Center records self-reported Alcohol Use Disorders Identification Tests (AUDIT) and Drug Abuse Screening Tests (DAST-10) for all adult burn admissions. This study assessed for association between AUDIT/DAST-10 scores and burn patient outcomes. ⋯ AUDIT and DAST-10 screens can identify burn patients with problematic substance use, allowing early intervention. Positive screening scores do not independently predict longer hospital stays, increased wound severity, or treatment noncompliance.
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The number of burns in Portugal remains considerably large and therefore constitutes a major public health problem. There is a shortage of studies describing the epidemiological and clinical impact of seasonality on burn centre admissions, particularly in high income countries. ⋯ Winter seems to be associated with older patients and with the most severe burns (deeper and more often needing surgery). This study was designed to fill the gap in seasonal burn profile in Portugal and it helps in establishing preventive strategies and better resource allocation.