OCCURRENCE OF MULTI-ORGAN DYSFUNCTION IN PEDIATRIC BURN PATIENTS - INCIDENCE AND CLINICAL OUTCOME

Kraft, Robert; Herndon, David N; Finnerty, Celeste C; Shahrokhi, Shahriar; Jeschke, Marc G

doi:10.1097/SLA.0b013e31828c4d04

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OCCURRENCE OF MULTI-ORGAN DYSFUNCTION IN PEDIATRIC BURN PATIENTS - INCIDENCE AND CLINICAL OUTCOME

Published Date:

Feb 2014

Publisher's site:

http://dx.doi.org/10.1097/SLA.0b013e31828c4d04 New Site Icon

Source:

Ann Surg. 259(2):381-387.

[PDF-1.10 MB]

Details:

Personal Authors:

Kraft, Robert ; Herndon, David N ; Finnerty, Celeste C ; Shahrokhi, Shahriar ; Jeschke, Marc G ;

Keywords:

[+]

Description:

Objective

To examine the incidence of single or multiple organ failure postburn and its resultant clinical outcomes during acute hospitalization.

Summary Background Data

Patient outcomes are inherently dependent on intact organ function; however, burn injury affects the structure and function of almost every organ, but especially lung, liver, kidney and heart. Therefore, single-organ failure and/or multiorgan failure (MOF) are thought to contribute significantly to postburn morbidity and mortality but to date no large trial examining the effects of MOF on postburn outcomes exists.

Methods

Incidence of MOF was monitored in 821 pediatric burn patients during acute hospitalization. Patients were divided into groups based on the incidence of single organ specific failure, MOF, and non-MOF. The DENVER2 score was used to assess organ specific scores for lung, liver, kidney and heart. The patient’s demographics, injury characteristics, and outcome parameters were recorded.

Results

Respiratory failure has the highest incidence in the early phase of postburn injury, and decreases starting 5 days postburn. Cardiac failure was noted to have the highest incidence throughout hospital stay. Incidence of hepatic failure increases with the length of hospital stay and is associated with a high mortality during the late phase of the acute hospital stay. Renal failure has an unexpectedly low incidence but is associated with a high mortality during the first three weeks postburn injury. Three or more organ failure is associated with very high mortality.

Conclusion

This is the first large study in burn patients to determine the incidence of organ specific failure and outcome. The results of this study confirmed the expected chronologic incidence of organ-specific failure and yield the long-term mortality of liver and renal failure. (NCT00673309)

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

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