Burn Injuries in People Who Used Drug, 2009 to 2017: A Case–Control Study in Shiraz, Southern Iran

Hoghoughi, Mohammad Ali; Marzban, Mohammad Reza; Shahrbaf, Mohammad Amin; Shahriarirad, Reza; Kamran, Hooman; Meimandi, Farzaneh Zahmatkesh; Salimi, Maryam

doi:10.1093/jbcr/irac005

Cited by 6 publications

(1 citation statement)

References 28 publications

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“…Caustic injuries are considered one of the most prevalent, as well as preventable accidental injuries. Children are among the highest groups at risk of these injuries due to their curiosity and ability to reach objects without discerning their harm and potential dangers[ 25 , 26 ]. In 2009, the Kids' Inpatient Database of the United States reported 807 cases of caustic injuries.…”

Section: Discussionmentioning

confidence: 99%

Utilization of chest tube as an esophagus stent in pediatric caustic injuries: A retrospective study

Salimi¹,

Shahriarirad²,

Esfandiari³

et al. 2022

WJCP

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BACKGROUND The management of caustic esophageal burns in the pediatric population has changed over the years, while the most optimal management with regards to effectiveness, availability, and cost-beneficent stays controvertible. AIM To describe how to utilize a chest tube for esophageal stenting in pediatrics. METHODS Data regarding the etiology, treatment, and complications of caustic injury in pediatrics over 10 years was collected retrospectively. Furthermore, data regarding the patient's follow-up who underwent esophageal chest tube (ECT) were collected. The ECT was prepared by carving a narrowed section in the chest tube while maintaining the radiopaque section. The ECT will then be positioned from the cricopharyngeal and exited through the nostril and fixed on the patient's cheek. RESULTS During the period of our study, data from 57 patients with an average age of 2.5 years (range 1-12; SD = 1.7) were obtained. The results showed that 89% of esophageal injury was due to alkaline and 9.4% were caused by acidic agents. The treatment methods showed that 29 patients (50.8%) recovered with dilatation alone. In 16 patients (28.06%), the esophageal repair was performed by using the colon, and in 5 patients (8.7%), other surgical methods were used and in 7 patients (12.2%), the ECT stents were used. ECT was inserted in 7 cases with a mean age of 2 (range: 1.5-3) years who were classified as grade IIB or III. Grading was performed by endoscopy assessment on the first day. Antibiotics and corticosteroids were administrated as initial medical management for all patients. ECT implantation was done during the first 8 d for 5 out of 7 cases (mean: 3.8 d). For the 2 patients, ECT was used after 27 (patient 6) d and 83 (patient 7) d. The reason for late stenting in these patients was a postponed referral to our center, in which patient 7 even received 4 dilation episodes before visiting our center. ECT was removed after an average of 44 d in the first 5 patients, while in the other 2 patients (6 and 7) was 2 and 1 wk, respectively. There was no complication related to, or failure of, stent placement. It is worth mentioning that none of the 7 ECT cases required gastrostomy or jejunostomy. CONCLUSION The ECT method introduced in our study can be used as a broadly available, economic, and easy-use facility for esophageal stenting, particularly in developing countries and emergency departments which have limited access to modern equipment. Further multicenter studies with higher volume patients are required for further deployment of this method.

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Section: Discussionmentioning

confidence: 99%

Utilization of chest tube as an esophagus stent in pediatric caustic injuries: A retrospective study

Salimi¹,

Shahriarirad²,

Esfandiari³

et al. 2022

WJCP

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Effects of a Spiritual Care Program on Body Image and Resilience in Patients with Second-Degree Burns in Iran

et al. 2023

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Cohort analysis of 50% lethal area (LA50) and associating factors in burn patients based on quality improvements and health policies

Shahriarirad,

Shekouhi,

Nabavizadeh

et al. 2023

Sci Rep

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Burn injuries are among the common traumatic injuries, which can be accompanied with lifelong morbidity and mortality. The Lethal Area Fifty Percent (LA50) index is another reliable outcome measurement tool that assesses the standard of medical care at burn centers. It is widely used as a benchmark for assessing the quality of burn care and is considered the percentage at which 50% of burn patients are expected to die because of burn-related injuries. We aimed to determine and compare the LA50 in burn patients admitted to Shiraz Burn Referral Centers in 2018–2021 and 2011–2018 with regard to improving the quality of special care and infection control in the new hospital. We conducted a retrospective cohort analysis on patients admitted to Amir al-Momenin Burn Injury Hospital in Shiraz, Fars, Southern Iran. Data were retrospectively gathered from March 2011 to January 2022, and subsequently analyzed with standard statistical analysis, and also multivariate and probability analysis. A total of 7382 patients with acute burns injuries were identified. Among them, 4852 (65.7%) patients were men, and the median age was 27 years [Q1–Q3 7–40; range 1–98]. Most of the patients were in the pediatric and early adulthood age range, with 76.2% being younger than 40 years old. The median TBSA was 24% [IQR 14, 43], and the median duration of hospitalization was 11 [IQR 11] days. Most injuries were secondary to flame and fire (33.5%; n = 2472). The mortality rate in our study was 19.0% (n = 1403). We evaluated our patients based on two main time intervals: March 2011 till February 2018 (n = 3409; 46.2%), and March 2018 to January 2022 (n = 3973; 53.8%). Based on multivariate analysis, the second interval of our study was significantly correlated with a more female patients, higher age, lower TBSA, less burn injuries due to scald, contact, but more frequent fire and flame injuries, and also lower mortality rate. Factors correlated with higher mortality included male gender, older age, shorter hospitalization duration, higher TBSA, etiology of fire and flame, and accidental burn injuries. A Baux score of 76.5 had a sensitivity of 81.1%, specificity of 87.3%, accuracy of 86.1% in predicting mortality among our patients. The mortality probability for the study intervals were 20.67% (SD 33.0%) for 2011–2018, and 17.02% (SD 29.9%) for 2018–2022 (P < 0.001). The LA50 was 52.15 ± 2 for all patients. This ammount was 50 ± 2% in 2011–2018, and 54 ± 2 in 2018–2022 (P < 0.001). The mean LA50 values showed significant improvements following significant modifications in our critical care for burn victims, including augmented intensive care unit capacity, prompt relocation of inhalation burn cases to the intensive care unit, establishing a well-trained multidisciplinary team, and improved infection control. To improve outcomes for burn patients in developing countries, major changes should be made in the management of burn patients and LA50 is a reliable assessment tool for evaluating the how these changes affect patient’s outcomes.

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Burn Injuries in People Who Used Drug, 2009 to 2017: A Case–Control Study in Shiraz, Southern Iran

Cited by 6 publications

References 28 publications

Utilization of chest tube as an esophagus stent in pediatric caustic injuries: A retrospective study

Utilization of chest tube as an esophagus stent in pediatric caustic injuries: A retrospective study

Effects of a Spiritual Care Program on Body Image and Resilience in Patients with Second-Degree Burns in Iran

Cohort analysis of 50% lethal area (LA50) and associating factors in burn patients based on quality improvements and health policies

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