Short and long term mortality following massive burn injury (>50% TBSA) in a UK burns centre

Abstract

IntroductionDespite advances in burn care, large burn injuries carry significant mortality risk. Although studies examining immediate mortality are available, little data is available regarding risk after discharge from hospital. This study aimed to determine short and long term mortality rate at a UK burns centre for patients with massive burn injuries. We were particularly interested to determine whether mortality rate for self inflicted injuries was present and whether this was by suicide. MethodsThe International Burn Injury Database (iBID) was interrogated to identify patients admitted with> 50% TBSA (total body surface area) injuries from January 2009- September 2019. Documented cause of death on death certificates were viewed for patients who died. General Practitioners were contacted to determine if discharged patients were alive. Descriptive statistics were generated. Results96 patients were identified. Mean age was 45.6 years (range 16.4–93.7) with male to female ratio of 2:1. Mean TBSA was 71.8% (range 50–99). Mortality was 71.9% and was higher in females (75.7% vs 69.8%). Overall mean revised Baux score was 130 (range 68–184). Nearly half were self-inflicted (49.0%) with higher TBSA (74.4%). Of 69 patients who died only 1 was after discharge. Coroner inquiry determined that this was caused by acute alcohol intoxication. Most of those who died did so within 60 days (91.3%), usually within 48 h (71.0%). Burn futility accounted for most deaths (71.0%) followed by multi-organ failure (14.5%). ConclusionsLarge burns carry significant mortality risk. Self-inflicted large burns carry a higher mortality which may be attributed to larger TBSA. In patients surviving to discharge long term prognosis is good. Patients with self-inflicted burns seem to not make a subsequent successful suicide attempt after discharge from hospital.