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. 2019 Jan 28:7:3.
doi: 10.1186/s41038-018-0140-1. eCollection 2019.

Survival analysis and mortality predictors of hospitalized severe burn victims in a Malaysian burns intensive care unit

Affiliations

Survival analysis and mortality predictors of hospitalized severe burn victims in a Malaysian burns intensive care unit

Henry Tan Chor Lip et al. Burns Trauma. .

Abstract

Background: Prognostic measures to determine burn mortality are essential in evaluating the severity of individual burn victims. This is an important process of triaging patients with high risk of mortality that may be nursed in the acute care setting. Malaysian burn research is lacking with only one publication identified which describes the epidemiology of burn victims. Therefore, the objective of this study was to go one step further and identify the predictors of burn mortality from a Malaysian burns intensive care unit (BICU) which may be used to triage patients at higher risk of death.

Methods: This is a retrospective cohort study of all admissions to Hospital Sultan Ismail's BICU from January 2010 till October 2015. Admission criteria were in accordance with the American Burn Association guidelines, and risk factors of interest were recorded. Data was analyzed using simple logistic regression to determine significant predictors of mortality. Survival analysis with time to death event was performed using the Kaplan-Meier survival curve with log-rank test.

Results: Through the 6-year period, 393 patients were admitted with a male preponderance of 73.8%. The mean age and length of stay were 35.6 (±15.72) years and 15.3 (±18.91) days. There were 48 mortalities with an overall mortality rate of 12.2%. Significant risk factors identified on simple logistic regression were total body surface area (TBSA) > 20% (p < 0.001), inhalation injury (p < 0.001) and presence of early systemic inflammatory response syndrome (SIRS) (p < 0.001). Survival analysis using Kaplan-Meier survival curve showed similar results with TBSA > 20%, presence of SIRS, mechanical ventilation and inhalation injury which were associated with poorer survival (p < 0.001).

Conclusion: The predictors of mortality identified in a Malaysian BICU were TBSA > 20%, early SIRS, mechanical ventilation and inhalation injury which were associated with poorer survival outcome. The immunological response differs from individual patients and influenced by the severity of burn injury. Early SIRS on admission is an important predictor of death and may represent the severity of burn injury. Patients who required mechanical ventilation were associated with mortality and it is likely related to the severity of pulmonary insults sustained by individual patients. This data is important for outcome prognostication and mortality risk counselling in severely burned patients.

Keywords: Burn; Degree; Inhalation injury; Mortality predictors.

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Conflict of interest statement

Ethical approval was granted by Ministry of Health Malaysia Medical Research Ethics Committee.Not applicable.The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplen-Meier survival curve of significant predictors of burn mortality. a Total body surface area (TBSA)>20%. b Inhalational injury. c Mechanical ventilation. d Early systemic inflammatory response syndrome (SIRS)

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References

    1. Seo DK, Kym D, Yim H, Yang HT, Cho YS, Kim JH, et al. Epidemiological trends and risk factors in major burns patients in South Korea: a 10-year experience. Burns. 2015;41:181–118. doi: 10.1016/j.burns.2014.05.004. - DOI - PubMed
    1. You K, Yang HT, Kym D, Yoon J, Yim HJ, Cho YS, et al. Inhalation injury in burn patients: establishing the link between diagnosis and prognosis. Burns. 2014;40:1470–1475. doi: 10.1016/j.burns.2014.09.015. - DOI - PubMed
    1. Jeschke MG, Pinto R, Kraft R, Nathens AB, Finnerty CC, Gamelli RL, et al. Morbidity and survival probability in modern burn care. Crit Care Med. 2015;43(4):808–815. doi: 10.1097/CCM.0000000000000790. - DOI - PMC - PubMed
    1. Resources for Optimal Care of the Injured Patient 2014. Available at https://www.facs.org/~/media/files/quality%20programs/trauma/vrc%20resou.... Accessed 18 June 2018.
    1. Bloemsma GC, Dokter J, Boxma H, Oen IMMH. Mortality and causes of death in a burn centre. Burns. 2008;34:1103–1107. doi: 10.1016/j.burns.2008.02.010. - DOI - PubMed