OUTCOMES IN DIABETICS WITH BURNS: AN OBSERVATIONAL STUDY

Abstract

SESSION TITLE: Critical Care 2 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 PM - 02:00 PM PURPOSE: Burn injuries in adults can be complicated due to various underlying factors. Of all the co-morbidities complicating wound healing and prognosis of the patient post burn injury, diabetes mellitus tops the list of etiologies.There is lack of research on burns among diabetic patients.We therefore elaborate the epidemiology, patient outcomes, infection and mortality rates, interventions and complications among diabetic burns patients. Aim:To analyze various demographic characteristics, clinical and microbiological profile, outcome of all diabetic burns patients in comparison with non-diabetic burns patients admitted to our tertiary care hospital. METHODS: This study was a retrospective analysis of diabetic and non-diabetic burns patients admitted to Apollo Speciality Hospitals, Vanagaram, a tertiary care facility in Chennai over a period of 3 years. Data such as age, gender, type and degree of burns, percentage of burns and length of stay, infection rates, type of infections, surgical procedures, medical complications and mortality rates were analyzed in comparison with non-diabetic burns patients. RESULTS: Among 94 burns patients admitted over a period of 3 years,18 patients(19%) had diabetes and 76 patients (81%) were non-diabetics. Mean age among diabetic was 58.2 years (SD-17.1) and among non-diabetic patient was 36.3 years (SD-16.4). Mean percentage of total body surface area involved in burns was 43.5% in diabetics and 49.75% in non-diabetics. Split skin graft was done in 50% diabetics and 48.7% non-diabetics. A higher infection rate (67%) was observed among diabetics than non-diabetic patients (61.8%). Blood stream infections was more common in diabetic patients (55.6%) than in non-diabetic patients (52.6%). Gram negative organisms isolated were 80% from diabetic patients and 73.4% from non-diabetic patients. Gram positives and fungi were isolated more among non-diabetics (19% and 7.5%) than diabetic patients (17% and 2%). Majority of organisms (68%) isolated from diabetic burns patients were Klebsiella species(22%), Pseudomonas species(20%), Acinetobacter baumannii(15%) and Escherichia coli(11%). Average length of stay of diabetes patients was 12.6 days and in non-diabetics, it was 16.2 days. A higher mortality rate (44%) was observed in diabetic as compared to 35% among non-diabetic. CONCLUSIONS: The progress and clinical course of burns patients were different among diabetic and non-diabetic patients. This analysis portrays the differences between these two groups of patients thereby directing the future course in managing burns patients. CLINICAL IMPLICATIONS: The awareness of clinical and microbiological profile in burns in diabetes mellitus patients may help guide specific therapy. This study reflects the subtle differences in burns patients among diabetes and non-diabetes patients. A multidisciplinary approach is essential early in the management to help improve outcome in burns patients. DISCLOSURES: No relevant relationships by Isabella Princess, source=Web Response No relevant relationships by EBENEZER RABINDRARAJAN, source=Web Response No relevant relationships by Nagarajan Ramakrishnan, source=Web Response No relevant relationships by Rohit Vadala, source=Web Response