Determinants of Mortality in Pediatric Patients with Greater than 70% Full-thickness Total Body Surface Area Thermal Injury Treated by Early Total Excision and Grafting

Dn, Herndon; Gore, Dennis C.; Cole, Michael; Mh, Desai; Linares, Hugo A.; Abston, Sally; Rutan, Thomas C.; T, Van Osten; Barrow, RE

doi:10.1097/00005373-198702000-00020

Cited by 112 publications

(37 citation statements)

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“…Initially, BULL & SQUIRE 2 defined their prediction of mortality after burn based on age and burn area. Nearly 50 years later, the importance of other factors such as pre-admission shock 6 , inhalation injury 19,21 , sepsis 10,15 and thrombocytopenia 7 have been identified. Over time, various reports have shown progressive improvement in mortality with advances in burn care 1,5,16 .…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of mortality in burn patients

Macedo¹,

Santos²

2007

Rev. Inst. Med. trop. S. Paulo

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SUMMARYBurn mortality statistics may be misleading unless they account properly for the many factors that can influence outcome. Such estimates are useful for patients and others making medical and financial decisions concerning their care. This study aimed to define the clinical, microbiological and laboratorial predictors of mortality with a view to focus on better burn care. Data were collected using independent variables, which were analyzed sequentially and cumulatively, employing univariate statistics and a pooled, cross-sectional, multivariate logistic regression to establish which variables better predict the probability of mortality. Survivors and non-survivors among burn patients were compared to define the predictive factors of mortality. Mortality rate was 5.0%. Higher age, larger burn area, presence of fungi in the wound, shorter length of stay and the presence of multi-resistant bacteria in the wound significantly predicted increased mortality. The authors conclude that those patients who are most apt to die are those with age > 50 years, with limited skin donor sites and those with multi-resistant bacteria and fungi in the wound.

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Section: Discussionmentioning

confidence: 99%

Predictive factors of mortality in burn patients

Macedo¹,

Santos²

2007

Rev. Inst. Med. trop. S. Paulo

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“…Inhalation injury of the lung in adults is usually proportional to the depth and extent of body surface area burned (252,279,342,440). Children have a lower rate of inhalation injury because of the prominence of scald injury in this group (200,320). Hypoxia occurs when the carbon monoxide generated by combustion is inhaled and binds to hemoglobin.…”

Section: Inhalation Injurymentioning

confidence: 99%

“…However, an improved understanding of the pathophysiology of burns allowed the advancement of multiple intra-and postoperative medical and surgical techniques that has resulted in gradual decreases in morbidity and mortality (66,87,127,181,196,200,470). Medical support to maintain hemodynamic and respiratory function within the trauma intensive care unit and operating theater, the provision of early adequate nutrition, and the use of surgical techniques that minimize blood and heat loss allowed this approach to become the standard of care for large thermal injuries in modern burn centers.…”

Section: Early Excision and Burn Wound Closurementioning

confidence: 99%

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Burn Wound Infections

Church

Elsayed

Reid³

et al. 2006

Clin Microbiol Rev

1,602

1,345

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SUMMARYBurns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices.

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“…These statistics have improved considerably with the advances in critical patients care, with current data showing a 50% mortality rate in children up to 14 with 98% TBSA and in young adults with over 75%TBSA 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Oxandrolone use in adult burn patients. Systematic review and meta-analysis

et al. 2014

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PURPOSE:This study is a systematic literature review and meta-analysis concerning the use of a testosterone synthetic analog, oxandrolone, and its use in severe adult burns. METHODS:Randomized prospective clinical studies, in English, Portuguese or Spanish, were sought on the following databases:MEDLINE, COCHRANE, EMBASE and LILACS. There was no restriction in relation to the publication date. RESULTS:This search produced 24 studies on MEDLINE and twelve articles were presented on the COCHRANE database .Sixteen were excluded due to the title not being related to this search or by including children. Of the eigth residual studies, after adaptation to the inclusion criteria, only four were selected. After analyzing the results, two were discarded since they did not present adequate patient characterization and the facts on these articles were analyzed differently from the others, hindering the meta-analysis. CONCLUSION:The analysis of the available data demonstrated significant benefits (p<0.05) considering lesser loss of corporal mass, lesser nitrogen loss, and shorter donor area healing time, when Oxandrolone was used, comparatively with the control group (placebo or not).

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Determinants of Mortality in Pediatric Patients with Greater than 70% Full-thickness Total Body Surface Area Thermal Injury Treated by Early Total Excision and Grafting

Cited by 112 publications

References 0 publications

Predictive factors of mortality in burn patients

Predictive factors of mortality in burn patients

Burn Wound Infections

Oxandrolone use in adult burn patients. Systematic review and meta-analysis

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