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. 2020 Sep;8(17):1053.
doi: 10.21037/atm-20-288.

Clinical features and mortality-related factors of extensive burns among young adults: the Kunshan disaster experience

Ying-Zi Huang  1 , Guo-Zhong Lu  2 , Hong-Sheng Zhao  3 , Li-Jun Liu  4 , Jun Jin  5 , Yun-Fu Wu  6 , Jian Wu  7 , Fu-Li Zhao  6 , Ning Liu  8 , Wen-Ming Liu  9 , Long Liu  10 , Tuan-Jie Zhu  11 , Er-Zhen Chen  12 , Qin Gu  13 , Hong-Wei Ye  14 , Xiu-Ming Xi  15 , Bin Du  16 , Yang Yi  1 , Hai-Bo Qiu  1
Affiliations

Clinical features and mortality-related factors of extensive burns among young adults: the Kunshan disaster experience

Ying-Zi Huang et al. Ann Transl Med. 2020 Sep.

Abstract

Background: The aim of the study was to identify the clinical features and the factors associated with burn induced mortality among young adults after exposure to indoor explosion and fire.

Methods: This is an observational study which included burn patients who were admitted to eighteen ICUs after a fire disaster. Epidemiologic and clinical characteristics, as well as therapy were recorded. The primary outcome was 90-day mortality. The mortality-related factors were also analyzed.

Results: There were 167 burn patients enrolled in the study, the median age was 38 years, 62 (37.1%) patients died within 90 days. Seventy-one percent of patients had a burn size ≥90% TBSA, and 73.7% of patients had a full-thickness burn area above 50% TBSA. The survivors had lower Baux scores, and received earlier escharectomy and autologous skin grafts. The 50% mortality rates (LA50s) for burn size and full-thickness burn area were 95.8% and 88.6% TBSA, respectively. The multivariate analysis showed that full-thickness burn area over 50% TBSA and residual burned surface area (RBSA)/TBSA at 28 days were strong predictors of mortality among burn patients (odds ratio 2.55; 95% CI, 1.01 to 6.44, P=0.047; odds ratio 1.07; 95% CI, 1.04 to 1.09, P<0.001). The ROC curve-based cut-off values of RBSA/TBSA at 28 days for predicting 90-day mortality were 62.5%.

Conclusions: Burn size and full-thickness burn area were the main risk factors for poor outcome in patients with extensive burns. Earlier escharectomy and autologous skin grafts may improve outcomes.

Keywords: Extensive burns; autologous skin grafts; escharectomy; mortality; residual burned surface area.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-288). All authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The relationship between burn area, thickness and mortality.
Figure 2
Figure 2
The relationship of burn surface area (A) and full-thickness burn area (B) with survival.
Figure 3
Figure 3
The ROC curve analysis of RBSA/total area at 28 days and at 60 days.
See this image and copyright information in PMC

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