Predicting mortality in burn patients with bacteraemia

Ceniceros, Alexandra; Pértega, Sonia; Galeiras, Rita; Mourelo, Mónica; López, Ellen D. S.; Broullón, Javier; Sousa, Dolores; Freire, David

doi:10.1007/s15010-015-0847-x

Cited by 22 publications

(17 citation statements)

References 28 publications

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“…In developed nations, the ageing individuals are the fastest growing populations especially in Europe and America [6]. In addition, the mean age of burn patients admitted for burn injury in developed nations of Canada and Spain was higher than 44.7 and 53 years old respectively [7, 8]. In comparison with a population from a developing nation of Ecuador, the injured were younger patients with a mean age of 33 years [9].…”

Section: Introductionmentioning

confidence: 99%

Survival analysis and mortality predictors of hospitalized severe burn victims in a Malaysian burns intensive care unit

et al. 2019

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BackgroundPrognostic measures to determine burn mortality are essential in evaluating the severity of individual burn victims. This is an important process of triaging patients with high risk of mortality that may be nursed in the acute care setting. Malaysian burn research is lacking with only one publication identified which describes the epidemiology of burn victims. Therefore, the objective of this study was to go one step further and identify the predictors of burn mortality from a Malaysian burns intensive care unit (BICU) which may be used to triage patients at higher risk of death. MethodsThis is a retrospective cohort study of all admissions to Hospital Sultan Ismail’s BICU from January 2010 till October 2015. Admission criteria were in accordance with the American Burn Association guidelines, and risk factors of interest were recorded. Data was analyzed using simple logistic regression to determine significant predictors of mortality. Survival analysis with time to death event was performed using the Kaplan-Meier survival curve with log-rank test.ResultsThrough the 6-year period, 393 patients were admitted with a male preponderance of 73.8%. The mean age and length of stay were 35.6 (±15.72) years and 15.3 (±18.91) days. There were 48 mortalities with an overall mortality rate of 12.2%. Significant risk factors identified on simple logistic regression were total body surface area (TBSA) > 20% (p < 0.001), inhalation injury (p < 0.001) and presence of early systemic inflammatory response syndrome (SIRS) (p < 0.001). Survival analysis using Kaplan-Meier survival curve showed similar results with TBSA > 20%, presence of SIRS, mechanical ventilation and inhalation injury which were associated with poorer survival (p < 0.001).ConclusionThe predictors of mortality identified in a Malaysian BICU were TBSA > 20%, early SIRS, mechanical ventilation and inhalation injury which were associated with poorer survival outcome. The immunological response differs from individual patients and influenced by the severity of burn injury. Early SIRS on admission is an important predictor of death and may represent the severity of burn injury. Patients who required mechanical ventilation were associated with mortality and it is likely related to the severity of pulmonary insults sustained by individual patients. This data is important for outcome prognostication and mortality risk counselling in severely burned patients.

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Section: Introductionmentioning

confidence: 99%

Survival analysis and mortality predictors of hospitalized severe burn victims in a Malaysian burns intensive care unit

et al. 2019

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“…Quite recently, Huang et al [16] developed a mathematical model of predicting mortality based on the admission characteristics including gender, age, the total burn area, the full thickness burn area, the inhalation injury, shock, and the period before admission in 6220 burn cases. Ceniceros et al [17] investigated the factors associated with mortality in burn patients and reported that age, the burn extent, and the SOFA score at the onset of bacteremia and recurrent bacteremia were significantly associated with the mortality. We did not investigate the bacteremia status of the participants.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting mortality among victims of electrical burns

Tiryaki¹,

Haksal²,

Yazıcıoğlu

et al. 2017

Ulus Travma Acil Cerrahi Derg

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“…S. aureus causes burn wound infection and failure of the skin graft, but seldom leads to mortality. Ceniceros et al (2015) conducted a retrospective study of adult patients with bacteremia and found that 17.5% of cases could be ascribed to Pseudomonas aeruginosa and 15.5% to Klebsiella pneumonia. S. aureus was the second most common cause of bacteraemia (Ceniceros et al, 2015).…”

Section: Burnsmentioning

confidence: 99%

“…Ceniceros et al (2015) conducted a retrospective study of adult patients with bacteremia and found that 17.5% of cases could be ascribed to Pseudomonas aeruginosa and 15.5% to Klebsiella pneumonia. S. aureus was the second most common cause of bacteraemia (Ceniceros et al, 2015). The most frequently isolated fungus was Candida species, which was increased during the hospital stay and peaked within the third and fourth week (Macedo & Santos, 2006).…”

Section: Burnsmentioning

confidence: 99%

Mouse Model of Burn Wound and Infection: Thermal (Hot Air) Lesion‐Induced Immunosuppression

2017

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The immunosuppression induced by thermal injury renders the burned victim susceptible to infection. A mouse model was developed to examine the immunosuppression, which was possible to induce even at a minor thermal insult of 6% total body surface area. After induction of the burn (48 hr) a depression of leukocytes in the peripheral blood was found of the burned mice. This depression was due to a reduction in the polymorphonuclear cells. The burned mice were not able to clear a Pseudomonas aeruginosa wound infection, since the infection spread to the blood as compared to mice only infected with P. aeruginosa subcutaneously. The burn model offers an opportunity to study infections under these conditions. The present model can also be used to examine new antibiotics and immune therapy. Our animal model resembling the clinical situation is useful in developing new treatments of burn wound victims. © 2017 by John Wiley & Sons, Inc.

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Predicting mortality in burn patients with bacteraemia

Abstract: In addition to conventional risk factors, recurrence and organ dysfunction at the onset of bacteraemia are also associated with mortality, while the pathogen involved is not a prognostic factor.

Cited by 22 publications

References 28 publications

Survival analysis and mortality predictors of hospitalized severe burn victims in a Malaysian burns intensive care unit

Survival analysis and mortality predictors of hospitalized severe burn victims in a Malaysian burns intensive care unit

Factors affecting mortality among victims of electrical burns

Mouse Model of Burn Wound and Infection: Thermal (Hot Air) Lesion‐Induced Immunosuppression

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