Measured Effect Magnitude of Comorbidities on Burn Injury Mortality

Abstract

Introduction-The ability to better prognosticate burn injury outcome is challenging and historically, most center use the Baux or revised Baux score to help prognosticate burn outcome, however, the weighted contribution of comorbidity on burn mortality has traditionally not been accounted for nor adequately studied. We therefore sought to determine the effect of comorbidities, using the Charlson comorbidity index (CCI) on burn mortality.

The prevalence of comorbidities among acute burn patients

“…According to these results, 18.5% of patients overall had comorbidities and 57% of old people had one or more comorbid conditions. In a recent large study with over 7000 patients, there was at least one comorbidity in 40% of burn patients 14 with another reporting that 26.4% of the adult burned population had one or more medical comorbidities 22 and a third showing that over 45% of elderly burn patients had a Charlson score of 2 or more. 15 In common with many other studies, our data show that those with comorbidities are older than those without, and the older the age, the higher the number of comorbidities and higher the Charlson comorbidity score.…”

“…15 In common with many other studies, our data show that those with comorbidities are older than those without, and the older the age, the higher the number of comorbidities and higher the Charlson comorbidity score. 14,15,18,19 Age, burn size (% TBSA), and presence of inhalation injury are the most important prognostic factors in burn patients, 23 but the effects of comorbidities on patients' outcome after burn injury are controversial, 15,24,25 with uncertainty as to whether comorbidities have an independent role in increasing the risk of mortality of burn patients regardless of age. 15 In this study, in-hospital mortality rate and hospitalization length were not significantly different between the two groups, but comorbid patients were significantly older and had a higher TBSA with higher Charlson comorbidity score.…”

“…Unfortunately the retrospective nature of this study meant that the control of the important confounding factors such as age, TBSA, and inhalation injury was not possible, so the independent impact of comorbidities on the patients' outcome could not be assessed, nor were we able to assess the connection between comorbidities and death within one year of discharge. Knowlin et al 14 demonstrated that comorbidities had significant impact on death rate following burns, with younger burn patients with preexisting medical comorbidities being more susceptible to worse prognosis.…”

“…Preexisting medical comorbidities have a significant effect on burn injury mortality rate in all age groups. 14 Despite the important effects of comorbidities on the outcome following burn injury, there is insufficient epidemiologic data, such as prevalence, reported in the literature but needs to be taken into account. 2,15 The aim of this study was to determine the prevalence of comorbid conditions among burn patients admitted to a tertiary burn hospital, so that future researchers may be helped to assess the impact of comorbidities on burn patients' outcomes.…”

“…Preexisting medical comorbidities have a significant effect on burn injury mortality rate in all age groups. 14 Despite the important effects of comorbidities on the outcome following burn injury, there is insufficient epidemiologic data, such as prevalence, reported in the literature but needs to be taken into account. 2,15…”