Contemporary Burn Survival

Details

• Alternative Title:
  J Am Coll Surg
• Personal Author:
  Capek, Karel D ; Sousse, Linda E ; Hundeshagen, Gabriel ; Voigt, Charles D ; Suman, Oscar E ; Finnerty, Celeste C ; Jennings, Kristofer ; Herndon, David N
• Description:
  BACKGROUND
  
  The standard of burn treatment today reflects major advances. We sought to quantitate the impact of these advances on burn survival via age-stratified mortality ratios compared to other reported mortality analyses in burns.
  
  STUDY DESIGN
  
  Age, percent of the total body surface area (TBSA) burned, presence of inhalation injury, length of stay, and survival status were recorded at admission and at discharge for all new burn admissions between 1989 and 2017. The expected mortality probability was calculated using historical multiple regression techniques and compared with observed data. We developed a prediction model for our observed data.
  
  RESULTS
  
  Between 1989 and 2017, there were 10,384 consecutive new burn admissions with 355 mortalities (median age: 13 years; median percent TBSA burn: 11%). We observed a significant decrease in our observed mortality data compared to historical predictions (p<0.0001) and a 2% reduction per year in mortality over the three decades. The prediction model of mortality for the data is as follows: Pr(dying) = ex/(1 + ex) where x = −6.44 − 0.12 age + 0.0042 age2 − 0.0000283 age3 + 0.0499 TBSA + 1.21 Inhalation Injury + 0.015 third degree TBSA.
  
  CONCLUSIONS
  
  The reduction in mortality over time may be attributed to successful changes in standard of care protocols in the burn center that improved the outlook for burned individuals, including protocols for management of inhalation injury, nutrition, resuscitation, and early excision and grafting.
  
  
• Subjects:
  Adolescent Adult Age Factors Body Surface Area Burns Child Child, Preschool Female Humans Infant Infant, Newborn Length Of Stay Male Middle Aged Retrospective Studies Survival Rate Young Adult

  More +
• Keywords:
  Age Inhalation Injury Prediction Model Standard Of Care Total Body Surface Area Burn
• Source:
  J Am Coll Surg. 226(4):453-463
• Pubmed ID:
  29530306
• Pubmed Central ID:
  PMC6027619
• Document Type:
  Journal Article
• Funding:
  UL1 TR000071/TR/NCATS NIH HHSUnited States/ ; U48 DP000043/DP/NCCDPHP CDC HHSUnited States/ ; R01 GM056687/GM/NIGMS NIH HHSUnited States/ ; P50 GM060338/GM/NIGMS NIH HHSUnited States/ ; T32 GM008256/GM/NIGMS NIH HHSUnited States/ ; UL1 TR001439/TR/NCATS NIH HHSUnited States/ ; R01 HD049471/HD/NICHD NIH HHSUnited States/ ; R01 GM112936/GM/NIGMS NIH HHSUnited States/
• Volume:
  226
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:759a6dd5cde8bb1ad201bf9bd51f50db0fcef2374066bebfe07061027487ee10
• Download URL:
  https://stacks.cdc.gov/view/cdc/56745/cdc_56745_DS1.pdf
• File Type:
  [PDF - 873.69 KB ]