Long-term survival after burns in a Swedish population

Pompermaier, Laura; Steinvall, Ingrid; Fredrikson, Mats; Thorfinn, Johan; Sjöberg, Folke

doi:10.1016/j.burns.2016.07.018

Cited by 10 publications

(5 citation statements)

References 31 publications

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“…This study showed an increased mortality rate in elderly burn patients within the first 5 years after discharge compared to the general population. This is in line with previous studies that assessed long-term mortality, ranging from 5 years to 33 years after injury/discharge [ 5 , 14 , 17 , 23 ]. However, other studies reported no differences in mortality rate [ 16 ] or even lower mortality rates in their burn population compared to the general population [ 24 ].…”

Section: Discussionsupporting

confidence: 92%

“…Unlike these well-known predictors of short-term outcomes, contradictory findings have been reported about long-term mortality in elderly and the association to burn injury [ 9 , 15 ]. Some studies observed no correlation between burn injury and long-term mortality in elderly [ 16 ], while others did [ 14 , 17 ]. This difference is probably related to the heterogeneity in those study populations and because they do not assess short-term and long-term mortality in one study.…”

Section: Introductionmentioning

confidence: 99%

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Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study

et al. 2023

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Background The population of elderly patients with burn injuries is growing. Insight into long-term mortality rates of elderly after burn injury and predictors affecting outcome is limited. This study aimed to provide this information. Methods A multicentre observational retrospective cohort study was conducted in all three Dutch burn centres. Patients aged ≥65 years, admitted with burn injuries between 2009 and 2018, were included. Data were retrieved from electronic patient records and the Dutch Burn Repository R3. Mortality rates and standardized mortality ratios (SMRs) were calculated. Multivariable logistic regression was used to assess predictors for in-hospital mortality and mortality after discharge at 1 year and five-year. Survival analysis was used to assess predictors of five-year mortality. Results In total, 682/771 admitted patients were discharged. One-year and five-year mortality rates were 8.1 and 23.4%. The SMRs were 1.9(95%CI 1.5–2.5) and 1.4(95%CI 1.2–1.6), respectively. The SMRs were highest in patients aged 75–80 years at 1 year (SMRs 2.7, 95%CI 1.82–3.87) and five-year in patients aged 65–74 years (SMRs 10.1, 95%CI 7.7–13.0). Independent predictors for mortality at 1 year after discharge were higher age (OR 1.1, 95%CI 1.0–1.1), severe comorbidity, (ASA-score ≥ 3) (OR 4.8, 95%CI 2.3–9.7), and a non-home discharge location (OR 2.0, 95%CI 1.1–3.8). The relative risk of dying up to five-year was increased by age (HR 1.1, 95%CI 1.0–1.1), severe comorbidity (HR 2.3, 95%CI 1.6–3.5), and non-home discharge location (HR 2.1, 95%CI 1.4–3.2). Conclusion Long-term mortality until five-year after burn injury was higher than the age and sex-matched general Dutch population, and predicted by higher age, severe comorbidity, and a non-home discharge destination. Next to pre-injury characteristics, potential long-lasting systemic consequences on biological mechanisms following burn injuries probably play a role in increased mortality. Decreased health status makes patients more prone to burn injuries, leading to early death.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study

et al. 2023

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“…The survivor’s follow-up of one year showed that 12% of the discharged patients died during this period. The majority of those deaths occur during the first three months after discharge from the BU, as observed in the Kaplan-Meier curve of cumulative survival, a result like those found in other studies [ 15 , 25 ].…”

Section: Discussionsupporting

confidence: 84%

Prognostic Scores for Mortality in Invasive Mechanically Ventilated Burn Patients

Costa,

Ferros,

Reigota

et al. 2024

Cureus

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Introduction: Managing burn patients is a challenge requiring a multidisciplinary team with the ability to predict complications and act early to avoid them. There are few studies characterizing the population of critically ill burn patients in need of ventilatory support. This study aimed to describe the population of burn patients in need of invasive mechanical ventilation support and assess in-hospital mortality and the factors associated with it. Material and methods: A longitudinal retrospective study was conducted, including burn patients admitted to a tertiary hospital burn unit over five consecutive years, who required invasive mechanical ventilation support during their hospitalization. Demographic data, comorbidities, characteristics of the injury scene, etiology, and characteristics of the burn were collected. Length of mechanical ventilation and hospitalization as well as mortality rate were evaluated. The determination of mortality predictors and the prognostic performance of mortality prediction scores were analyzed. A one-year follow-up was performed to evaluate the survival of discharged patients. Results: A total of 141 patients were included in this study; 68.1% patients were male with a median age of 58 years. The mean percentage of total body surface area (TBSA) burned was 24.5%. Home incidents were the most frequent, and fire was the most common cause of burns (80.9% of patients). The mean Abbreviated Burn Severity Index Score (ABSI) was 7.83, with an area under the curve in receiver operating characteristic curve (ROC) analysis (AUC_ROC) of 0.725; the mean Belgium Outcome of Burn Injury (BOBI) score was 3.45, with AUC_ROC of 0.740 and mean R-Baux of 89.1 and AUC_ROC of 0.834. The mean duration of invasive mechanical ventilation was 16.9±19.3 days. Age (p<0.001), length of mechanical ventilation (p<0.001), length of hospitalization (p<0.001), higher degree of burn (p=0.001), TBSA (p=0.040), and the presence of buttock burn (0.006) were associated with mortality in this sample. In-hospital mortality was 29.8%. The survival group had a 12% death rate at one-year follow-up, mostly in the first three months after discharge. Conclusion: Age, duration of mechanical ventilation, length of hospitalization, higher degree of burn, TBSA, and the presence of buttock burn were associated with mortality in this sample. R-Baux score was the most accurate test score to predict mortality in this challenging group of patients.

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“…In these early deaths, we observed that the patients were older and had more severe burn injury, which corresponds partly to the results from a Swedish cohort of burn patients, where older age increased the risk of rapid death after discharge (33). Two population-based cohort studies followed burn patients for many years after hospital discharge and revealed increased all-cause mortality compared to matched controls.…”

Section: Mortality During Follow-upsupporting

confidence: 79%

Long-Term Outcome After Renal Replacement Therapy in Severe Burns

Rakkolainen

Mustonen

Vuola

2020

Journal of Burn Care &Amp; Research

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Abstract Acute kidney injury is a common sequela after major burn injury, but only a small proportion of patients need renal replacement therapy. In the majority of patients, need for renal replacement therapy subsides before discharge from the burn center but limited literature exists on long-term outcomes. A few studies report an increased risk for chronic renal failure after burn injury. We investigated the long-term outcome of severely burned patients receiving renal replacement therapy during acute burn injury treatment. Data on 68 severely burned patients who received renal replacement therapy in Helsinki Burn Centre between November 1988 and December 2015 were collected retrospectively. Thirty-two patients survived and remained for follow-up after the primary hospital stay until December 31, 2016. About 56.3% of discharged patients were alive at the end of follow-up. In 81.3% of discharged patients, need for renal replacement therapy subsided before discharge. Two patients received renal replacement therapy for longer than 3 months; however, need for renal replacement therapy subsided in both patients. One patient required dialysis several years later on after the need for renal replacement therapy had subsided. This study showed that long-term need for renal replacement therapy is rare after severe burn injury. In the vast majority of patients, need for renal replacement therapy subsided before discharge from primary care. Acute kidney injury in association with burns is a potential but small risk factor for later worsening of kidney function in fragile individuals.

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Long-term survival after burns in a Swedish population

Cited by 10 publications

References 31 publications

Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study

Short-term and long-term increased mortality in elderly patients with burn injury: a national longitudinal cohort study

Prognostic Scores for Mortality in Invasive Mechanically Ventilated Burn Patients

Long-Term Outcome After Renal Replacement Therapy in Severe Burns

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