Burn Patients Research Articles

Isolation and characterization of bacteriophages targeting methicillin-resistant Staphylococcus aureus (MRSA) from burn patients and sewage water: a genomic and proteomic study.

The spectrum of infections caused by methicillin-resistant Staphylococcus aureus (MRSA) ranges from minor conditions to potentially life-threatening diseases. The rising antibiotic resistance in MRSA often leads to treatment failures, underscoring the urgent need for novel eradication strategies. This study focuses on isolating MRSA from burn patients, determining its antibiogram profile, and isolating and characterizing bacteriophages from sewage water that target MRSA, alongside conducting genomic analysis of the phages. A total of 70 samples were collected from burn patients, with MRSA identification and characterization performed using a combination of biochemical and molecular techniques, as well as antibiotic sensitivity testing. Based on host range analysis, a specific phage (phage-3) was selected for detailed characterization, including proteomic analysis, genetic mapping, phylogenetic studies, and analysis of open reading frames (ORFs) and motifs. The prevalence of MRSA in the samples was found to be 28.6%. Antibiotic susceptibility tests indicated that 94% of the MRSA isolates were sensitive to tobramycin and gentamicin, while vancomycin exhibited the lowest sensitivity, with only 2% effectiveness. Using the soft agar overlay method, three bacteriophages (phage-1, phage-2, and phage-3) were successfully isolated from sewage water. Among these, phage-3 exhibited the broadest host range. Further analysis showed that phage-3 demonstrated optimal activity at pH levels between 6 and 8, and within a temperature range of 20-40°C. Phage-3 also displayed a rapid adsorption phase within the first 0-5min, and its one-step growth curve revealed a latent period lasting up to 30min, followed by a significant increase in titer from 30 to 50min. Proteomic analysis of phage-3 identified the presence of 33kDa and 65kDa proteins. Phylogenetic analysis showed that phage-3 shares 96.6% similarity with Mammallicoccus phage vB_MscM-PMS3. The ORF analysis identified 80 potential ORFs within the phage's entire genome.

Donor site healing response to low-level laser therapy following skin graft surgery

IntroductionSkin grafting is an essential reconstructive technique for the healing of deep and extensive burns. Donor site problems are common complications after skin graft surgery. Speeding up the healing process at the donor site using low-level laser therapy helps avoid these problems. Objectives: The purpose of this research was to examine the efficacy of low-level laser therapy in promoting donor site healing in burn patients who underwent skin graft surgery.MethodsForty patients of both genders (16 male, 24 female) aged 20–40 years suffered full-thickness burns with a total body surface area varying from 20 to 35% and had undergone split-thickness skin graft surgery were selected randomly and divided into two equal groups. The low-level laser therapy group (study group) attended three sessions per week for three weeks, while the placebo group (control group) received sham laser treatments. All patients received conventional medical treatment and traditional wound care (dressing). Photography and J Image software were used to measure wound surface area before the treatment (day 1 post-operative), day 11 post-operative, and day 21 post-operative in both groups.ResultsThe study and control groups demonstrated a substantial reduction in wound surface area at day 11 and day 21 post-operative compared with day 1 (<i>p</i> < 0.001), with the percentage of improvement of 88.69% and 98.73% and 50.18% and 80.22%, respectively. On day 21 compared to day 11 (<i>p</i> < 0.001), the percentage of improvement was 88.81% and 60.30%, respectively. Between-group comparisons revealed a significant decrease in wound surface area at day 11 and day 21 post-operative in the study group compared to the control group (<i>p</i> < 0.001).ConclusionsLow-level laser therapy is an effective modality for enhancing wound healing of the donor site in burned patients undergoing skin graft surgery.

Timing of Renal Replacement Therapy in Burn Patients With Acute Kidney Injury: A Retrospective Cohort Study.

Acute kidney injury (AKI) is common in severe burns with high mortality. Previous studies confirmed the renal replacement therapy (RRT) as an effective strategy in burn patients. However, the optimal timing of RRT initiation with AKI is rarely investigated. We conducted a single-center, retrospective cohort study at a large burn center in Chongqing, China, from 2010 to 2020. Patients were grouped into early (initiated at Kidney Disease: Improving Global Outcomes stage 1 or 2 of AKI) and delayed RRT (initiated at Kidney Disease: Improving Global Outcomes stage 3 of AKI). The primary outcome was in-hospital mortality. The secondary outcomes included renal function recovery, length of stay, and RRT-related complications. Of the included 79 patients, 42 and 37 were in early and delayed RRT group, respectively. The mean burn area was 68.82%. The in-hospital mortality tended to be higher in the early group (42.86%) than in the delayed group (29.73%, P = 0.227), although the difference was not statistically significant. The rate of partial remission of renal function at 48 hours after RRT discontinuation was significantly higher in the delayed group (78.26%) than early group (36.84%, P = 0.003). Furthermore, multivariable Cox and logistic regression analysis found that interval from AKI occurrence to RRT initiation was protective factors for 90-day mortality (hazard ratio 0.514, 95% confidence interval 0.349-0.756, P = 0.001), but fluid overload, acute respiratory distress syndrome, and multiple organ dysfunction syndrome were risk factors for mortality. Subgroup analysis revealed that patients with stage 1 or 2 AKI who received RRT within 24 hours after AKI had the lowest survival rate. In contrast, patients with stage 3 AKI who received RRT beyond 24 hours after AKI had the highest survival rate. The delayed group had higher rate of bleeding and lower rate of catheter-related infection than the early group. Delayed initiation of RRT seemed to have similar survival benefits to early RRT initiation in burn patients with AKI, needing further confirmation by large randomized clinical study in future.

Pain management with virtual reality in burn patients: a literature review.

Burns are injuries to the skin or the underlying tissue system caused by heat, radiation, electricity, friction or chemicals. Burns can cause pain and discomfort during dressing changes; a person's pain response varies depending on individual perception. The pain response can indicate tissue damage in the body, as pain causes a person to experience discomfort. Pain can be interpreted as a subjective sensory response and an unpleasant emotional experience associated with actual or potential tissue damage. Pain is usually managed with pharmacological and non-pharmacological therapy. An example of non-pharmacological therapy is the use of distraction techniques, such as virtual reality (VR). VR diverts pain by creating a 3D environment with a screen and VR glasses. It allows the patient to immerse themselves in a virtual world complete with sound and music. The volume can be adjusted as needed and the patient can interact with the virtual world. The purpose of this study is to determine the characteristics and effectiveness of VR pain management in burn patients. The method used in this study is a literature review using the Preferred Reporting Items For Systematic Review (PRISMA). The authors searched for journal articles using the Science Direct, PubMed, and Google Scholar databases, covering the period from 2015-2023. The keywords used were pain management, virtual reality and burn injury. Based on the predetermined inclusion criteria, 10 articles were selected for the review. The results of this study, based on the analysis of 10 articles, indicated that the distraction or transition method (non-pharmacological management using VR) was effective in reducing pain and discomfort during dressing changes in patients with mild to moderate burns, across various age groups from infants and children to adults. Clinicians can leverage VR technology to tailor interventions based on individual patient needs, across all age groups, enhancing patient comfort and engagement during procedures.

The best stress ulcer prophylaxis in burn patients: The gap between research and practice

The best stress ulcer prophylaxis in burn patients: The gap between research and practice

Enrichment of H3S28p and H3K9me2 Epigenetic Marks on Inflammatory-Associated Gene Promoters in Response to Severe Burn Injury

Background: Severe burns activate systemic inflammation and lead to an increase in cytokine levels. Epigenetic elements are key regulators of inflammation; however, their involvement in severe burns has not been studied. In this work, we aimed to unveil the histone H3 posttranslational modifications (PTM) profile and their enrichment in promoters of inflammatory genes in response to severe burns. Methods: The levels of H3 PTMs were analyzed by ELISA assays in circulating cells from burn patients. ChIP assays were conducted to evaluate the enrichment of H3K9me2 and H3S28p at the promoter of CXCL8, IL-17, TNFA, IL-6, FOS, and IL-1B genes. Results: We found that eight H3 PTMs decreased at 5 days post-burn. Burn patients showed a decreased enrichment of H3K9me2 in CXCL8, IL-17, and TNFA promoters, whereas IL-6, FOS, and IL-1B promoters displayed an H3S28p enrichment diminution during the first 10 days post-burn. Interestingly, burn-injured septic patients exhibited an increased enrichment of H3K9me2 in TNFA, IL-1B, CXCL8, and IL-17 promoters, whereas H3S28p was increased in promoters of TNFA and IL-1B at 1 dpb. Conclusion: Severe burns trigger epigenetic changes and differential H3 PTM enrichment at inflammation gene promoters. Epigenetic misregulation of H3 may be involved in sepsis occurrence after severe burn injury.

The Impact of Platelet Transfusion on Prognosis in Adult Burn Patients with Thrombocytopenia: A Propensity Score Matching Analysis

Background and ObjectivesThrombocytopenia is common among burn patients. Platelet transfusion is frequently administered to increase platelet counts. However, it is not clear whether platelets affect the outcome after transfusion among adult burn patients with thrombocytopenia or not. Our aim is to explore whether platelet transfusion affects the prognosis of adult burn patients with thrombocytopenia. Materials and MethodsWe undertook a retrospective analysis of 368 adult burn victims with thrombocytopenia from the Department of Burn at the First Affiliated Hospital of Nanchang University, China, from January 2014 to July 2021. Propensity score matching (PSM) was utilized to reduce the selection bias and confounding factors. After PSM, both platelet transfusion group and no platelet transfusion group had 46 patients. Our primary outcome was 30-day all-cause mortality. ResultsLogistic multivariate regression analysis showed that third-degree burn area [β=-0.040, odds ratio (OR) =1.052, 95% confidence interval (CI) =1.015-1.091] and platelet transfusion (OR =2.227, 95% CI =0.473-10.483) were independent risk factors (P<0.05). KaplanMeier risk curve analysis showed that the 30-day mortality of patients in the platelet transfusion group and no platelet transfusion group were 47.8% and 19.6%, respectively (P<0.05) ConclusionPlatelet transfusion was an independent risk factor for 30-day mortality in adult burn patients with thrombocytopenia.

Development and performance evaluation of a clinical prediction model for sepsis risk in burn patients.

Sepsis is a common and severe complication in burn patients and remains one of the leading causes of mortality. This retrospective study aimed to develop a predictive model for the risk of in-hospital sepsis among burn patients treated at Guangzhou Red Cross Hospital between January 2022 and January 2024, with the goal of improving clinical outcomes through early prevention based on risk stratification. A total of 302 eligible patients were randomly divided into training and validation cohorts in a 7:3 ratio for model development and validation, respectively. Predictive factors were initially selected using LASSO regression, followed by logistic regression analysis to establish the prediction model and construct a nomogram. The final model incorporated 4 independent predictors: burn area (odds ratio [OR] = 1.043, 95% confidence interval [CI]: 1.026-1.062/1%), hemoglobin (OR = 0.968, 95% CI: 0.954-0.980/1 g/L), diabetes (OR = 10.91, 95% CI: 2.563-56.62), and potassium (OR = 3.091, 95% CI: 1.635-6.064/1 mmol/L). The areas under the receiver operating characteristic curve were 0.875 and 0.861 for the training and validation cohorts, with Youden indexes of 0.634 and 0.600, respectively. The calibration curve and decision curve analysis demonstrated good predictive accuracy and clinical utility of the model. These findings suggest that our developed model exhibits robust predictive performance for the risk of in-hospital sepsis in burn patients, and early prevention strategies based on risk stratification may potentially improve clinical outcomes.

Epidemiology of burn injuries in a Canadian population during the COVID-19 pandemic

ObjectiveThe COVID-19 pandemic affected burn injury patterns in many countries, but literature on this topic in Canada is limited. The objective of this study is to investigate the changes in...

Our experience of treatment of purulent arthritis in lower extremities after burn injury

BackgroundThe burn wound is directly affected by the general condition of the patient and also has a direct impact on the same leading to conditions pathology of the musculoskeletal system. Purulent arthritis is a pathological condition in which the joints of the body get inflamed as a result of bacterial infection.The aim of the present study was identification of purulent arthritis patients and to evaluate different surgical treatment in burn patients’ low extremities. Material and methodsDuring a 11-year period, 39 patients with burn injuries complicated by purulent arthritis of the joints of the lower extremities treated in the burn department of the Samarkand Center of Emergency Medical Care, Samarkand, Uzbekistan between 2010 and 2020 were enrolled in the present study. The diagnosis is made on the basis of a characteristic anamnesis. Blood tests confirming the presence of acute inflammation. The main diagnostic method purulent arthritis is puncture of the joint with subsequent examination of the punctate. All patients received comprehensive general and local treatment included necrotomy, necrectomy and 1 to 3 operations were performed to plastically close deep and large burn wounds. We performed an arthrotomy in 31 patients. In all cases, arthrotomy was performed as a planned surgical intervention. Unfortunately we performed amputation in 8 patients. ResultsIn the postoperative period, drainage of the joint cavity through the opening and wound, the application of paraphene to the surrounding tissues of the joints, massage, physical therapy, treatment physical physiotherapy exercises, laser application made it possible to achieve satisfactory results. ConclusionsThe described herein method of treatment of purulent arthritis of the lower extremities has improved treatment results, expanded survival rates, reduced probability of complications and disabilities.

An Epidemiological Survey of Hand Burn Injuries Admitted to a Large Burn Center in the New York City Metropolitan Area.

Hand form and function play a vital role in daily living, and even minor trauma can significantly impair quality of life. There is a current paucity of data regarding hand burn patient and injury characteristics, particularly in urban areas in the United States. As the field of hand surgery expands, a demographic understanding of patients with severe injury potentially requiring surgical management is imperative. The aim of this study was to define the epidemiological characteristics of burn injuries involving the hand that were admitted to a large New York City burn center. A retrospective review of the electronic health record was conducted to identify all patients admitted to our burn center with burn injury involving the hand from August 2020 to December 2023. Patient demographics, injury etiology and characteristics, and hospital course details were recorded and analyzed. We identified 96 admitted patients with 140 hand burn injuries, with a patient median age of 38 years. Female patients presented to the hospital significantly later after initial injury than male patients and were more likely to suffer from flame-related injury. The median length of stay for initial admission was 17.5 days, with longer length of stay associated with hypertension comorbidity. Patients experiencing homelessness demonstrated higher rates of psychiatric disorder, substance use, and current smoking. Length of follow-up was positively correlated with estimated household income. Compared to the general city population, the patient cohort was made up of a lower percentage of "White alone" and "Asian alone" race categories and higher percentage of persons experiencing homelessness. We report the clinical and social characteristics of burn patients with hand involvement admitted to a large urban burn center. Hand burn injuries have distinct risk factors and morbidity implications, and consideration for higher-risk groups is imperative for optimal prevention, acute management, and long-term support.

Life Satisfaction After Burn Injury—A Comprehensive Review

Burn injuries can have long-lasting effects not only on a person’s bodily integrity but also on their psychosocial well-being. Since medical advancements have increased survival from burn injuries, improving psychosocial health has become a pivotal goal for burn rehabilitation. Besides health-related quality of life, life satisfaction has become an important parameter for evaluating long-term outcomes after burns. We reviewed life satisfaction after burns among adult burn patients to evaluate the current assessment methods and gain insight into recovery patterns. PubMed, EMBASE, Medline, and Cochrane Library were searched systematically for studies in the English language covering life satisfaction after burns, resulting in the inclusion of 18 studies. The Satisfaction With Life Scale (SWLS) was the most commonly used assessment tool. Others included the Life Satisfaction Index-A (LSI-A) and a non-standardized tool. Most studies’ recovery patterns showed a decreased life satisfaction post-burn injury. There was strong agreement that inhalation injury, body dysfunction, an extended hospital stay, and psychological illness before the injury are possible determinants of post-burn life satisfaction and have shown a negative correlation. There seems to be a consistent use of assessment tools, which opens up the possibility of a further comparative investigation to better understand factors that influence life satisfaction after a burn so that this knowledge can be used to improve patients’ recovery.

Ten-Year Retrospective Analysis of Continuous Renal Replacement Therapy in Burn Patients: Impact on Survival and Timing of Initiation.

BACKGROUND Acute kidney injury (AKI) is a common issue in intensive care units and is a potentially lethal consequence of severe burns. In severely burned patients with non-renal indications, renal replacement treatment is frequently used. This study's aim was to compile a 10-year summary of continuous renal replacement therapy (CRRT) experience at a single burn center, including patient outcomes, effectiveness, and potential complications in the context of severe burns. MATERIAL AND METHODS This retrospective analysis included the clinical data from 723 burned patients. The data analysis of 300 patients with CRRT therapy included clinical data, laboratory tests, and CRRT parameters. The study group was split into 2 subgroups regarding onset of CRRT: early (up to 7 days after the trauma) and late. RESULTS Age, burn extent, length of stay, and inhalation injury all had an impact on survival. Early CRRT was linked to a greater probability of death (P<0.005). Upon admission to the burn center, patients with early CRRT exhibited a bigger burn area, higher Baux and SOFA scores, and were younger (P<0.05). Sepsis was diagnosed more frequently in the late CRRT group. CONCLUSIONS Our findings show that patients who require CRRT within the first 7 days following a burn injury have a poorer prognosis; however, this is not due to CRRT's effect, but rather to the trauma's severity. Future studies should explore long-term patient outcomes of CRRT among burn patients.

Clinical Profile and Outcome of Burn Injuries amongst Children in a Tertiary Care Center of North India

Objectives: The study aims to describe the clinical characteristics and outcome of pediatric burn patients admitted to a tertiary care hospital. Patients and methods: This was a cross-sectional, retrospective study that reviewed the records of all burn victims aged 0 to 12 who were admitted in a tertiary care hospital in North India over one year. Collected data included patient demographics such as age, gender, burn causal agents, discharge time, Total body surface area (TBSA) burnt by using Lund and Brauder’s Rule, the duration of stay, the season and month of admission that burn occurred, and burn characteristics, such as region of body involved, percentage of area burnt, complications and outcome. Results: 129 paediatric burn patients under 12 were included with median age of 4 years. Scald caused the majority of burns (81.4%), followed by dry burns (14.7%) and electric injuries (3.9%). The Median burn percentage was 20 and most burn patients were encountered during the winter season. The face and neck (56.6%) were involved in majority of cases, with a 4.6% overall mortality rate. Conclusion: This retrospective study provides valuable insights into the clinical profile of burn patients admitted to a tertiary care center in North India. The study's findings can help guide the development of targeted interventions and resource allocation to improve burn care in this region, ultimately reducing morbidity and mortality among burn patients.

Distribution and Antibiotic Sensitivity of Burn Wound Colonization in Referred Patients at the Burn Care Centre, PIMS, Islamabad, Pakistan

ABSTRACT Background: Burn injuries represent a significant health challenge worldwide due to their high mortality and disability rates. These wounds often become prone to infection due to compromised immunity and disrupted blood vessels at the injury site. Timely surgical excision, coupled with topical chemotherapy, has notably reduced mortality rates in burn patients. Objective: The objective of this study was to determine the prevalence of common bacterial infections among referred patients, with a minimum delay of one week, and to assess their bacteriological susceptibility at the Burn Care Centre, PIMS, Islamabad. Methods: This retrospective descriptive study was conducted between March 2021 and February 2023. We reviewed wound swab culture results spanning 24 months, primarily from referred patients. Wound specimens were collected using sterile swabs and standard techniques from registered patients, then analyzed at the microbiological laboratory based on patients' culture reports. Results: A total of 226 culture reports were assessed, comprising 95 (42.04%) male patients and 131 (57.96%) female patients, with a mean age of 21 years (range: 11 months to 65 years). Among these reports, 16 (7.08%) showed no growth. Pseudomonas aeruginosa was identified in 88 patients (38.93%), while Staphylococcus aureus (MRSA) was present in 57 (25.22%), Klebsiella pneumoniae in 36 (15.93%), and a combination of Klebsiella and Pseudomonas in 18 (7.96%) cases, as per the swab culture reports. Escherichia coli was detected in 3 (1.33%) cases and Enterobacter in 2 (0.88%) cases. Other bacteria were found in 6 (2.65%) swab culture reports. Pseudomonas and Klebsiella exhibited maximum susceptibility to Polymyxin B, at 67.04% and 61.11%, respectively, while MRSA showed the highest susceptibility to linezolid, at 89.47%. Conclusion: Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae were the most prevalent bacteria among patients referred to our Burn Care Center. Referred burn patients were found to be colonized with multi-drug resistant bacteria, compared to inpatient cases at our center.

Differentiation of antimicrobial toxicity and sepsis-induced disseminated intravascular coagulation in an orthopedic burn patient in India: a case report

Differentiation of antimicrobial toxicity and sepsis-induced disseminated intravascular coagulation in an orthopedic burn patient in India: a case report

Predicting Mortality in Severe Burns: A Comparison of Four Mortality Prediction Scores and the Role of Organizational Changes in the Croatian Burn Center

Background: The primary aim of this study was to evaluate the performance of four burn prognostic scores—Abbreviated Burn Severity Index (ABSI), Ryan, Belgium Outcome Burn Injury (BOBI), and revised Baux score (rBaux) in a Croatian burn center. A secondary aim was to compare patient outcomes before and after the organizational and protocol changes. Methods: A retrospective study and comparison of four prediction scores was conducted over a nine-year period in burn patients with ≥20% total body surface area (TBSA) burned. Additionally, outcomes before and after organizational changes were compared. Results: A total of 149 patients were included, with the mean patient age of 54.62 ± 19.38 years, the mean of TBSA of 42.98 ± 19.90, and an overall mortality rate of 48.99%. The area under the ROC curve (AUROC) was 0.79 for the rBaux and ABSI score, 0.77 for the BOBI score, and 0.76 for the Ryan score. The duration of mechanical ventilation and length of stay (LOS) in burn intensive care units (BICU) decreased after the organizational changes, though survival rates remained similar. Conclusions: Prognostic scores are good predictors of mortality but with moderate predictive accuracy. Continuity of care in intensive care could be important for better outcomes.

Mortality in the Burn Intensive Care Unit (2017-2023) at Mohammed VI University Hospital, Department of Reconstructive and Aesthetic Surgery, Marrakech

This internal audit aims to evaluate the management of burn patients in the intensive care unit (ICU) of Mohammed VI University Hospital in Marrakech, a specialized burn treatment center in Morocco. The retrospective study spans from 2017 to 2023, analyzing the deaths of 27 patients admitted to the ICU, with an average age of 62. The primary causes of death identified were septic shock (54%) and acute respiratory distress syndrome (18%). Key challenges emerged, including nursing staff shortages, inadequate stock management of dressing materials, and the absence of care assistants, all of which impacted the quality of care provided. The study also underscores the importance of improved care organization, drawing from international best practices. The report proposes several solutions, such as increasing nursing staff, optimizing workflows, and improving sanitary infrastructure to minimize infection risks. A crucial recommendation involves reassessing admission criteria to ensure that critically ill patients are redirected to appropriate units, particularly by strengthening the presence of full-time intensivists in the burn ICU. Furthermore, the report highlights the need for continuous training of medical personnel and interdisciplinary collaboration to enhance the quality of care. The introduction of assistive technologies and companion programs for isolated patients would also improve their nutritional and psychological support. These initiatives could alleviate the burden on medical staff and improve patient outcomes. By implementing these recommendations, the burn ICU could be transformed into a model of excellence, providing optimal, safe, and respectful care tailored to the individual needs of burn patients. This audit serves as a foundation for ongoing improvement, emphasizing patient safety and well-being as the core priorities in burn patient management.

Characteristics and outcomes of myocardial infarction among burn patients: A nationwide analysis

PurposeTo examine the characteristics and outcomes of myocardial infarction (MI) among burn patients. Materials and MethodsThe Nationwide Readmissions Database was utilized to identify hospitalizations of patients with burns from 2016 to 2020. The main outcome was the difference in all-cause in-hospital mortality between burn patients with and without MI. ResultsOf 200,130 hospitalizations with burns, 1997 (1 %) developed acute MI. Burn patients with MI were older, more likely to be men, and had a higher prevalence of cardiovascular risk factors. Only burns affecting the trunk and respiratory tract, and those affecting > 20 % of body surface area (BSA), were associated with an increased risk of MI. All-cause in-hospital mortality was higher among patients with MI (18.7 % vs. 3 %, adjusted odds ratio (aOR) 4.59, 95 % confidence interval (CI) 3.66, 5.76). Cardiogenic shock, ventricular tachycardia, and stroke rates were higher among patients with MI. Revascularization was associated with lower in-hospital mortality (aOR 0.33, 95 % CI 0.17, 0.64) ConclusionsThe incidence of MI in burn patients is low but is associated with high mortality and morbidity. Burns involving the trunk and respiratory tract, and those affecting > 20 % BSA, were associated with an increased risk of MI. Revascularization was associated with lower in-hospital mortality.

Epidemiology of elderly burn patients in the United States: Mortality patterns and risk factors revealed by CDC WONDER database

IntroductionBurn-related fatalities pose a significant global public health challenge, with a substantial impact on the elderly population. This study examines two decades of burn-related mortality data in the United States, aiming to understand the trends, disparities, and contributing factors among adults aged 65 and older. ObjectivesThe primary objectives of this study are to (1) analyze the trends in burn-related mortality rates among older adults, (2) investigate disparities based on gender, race and geographic regions, and (3) identify comorbidities and complications associated with burn-related deaths in this demographic. MethodsData were obtained from the Centers for Disease Control and Prevention (CDC) using the National Center for Health Statistics database. The study cohort consists of individuals aged 65 and older who experienced burn-related deaths between 1999 and 2020. Various demographic variables, including age, sex, race/ethnicity, and location of death, were considered. The study also examined urban-rural classifications and regional differences. Mortality rates were calculated and adjusted for age. Joinpoint regression analysis was employed to assess trends in age-adjusted mortality rates over time. Modes of death and common comorbidities and complications were analyzed. ResultsBetween 1999 and 2020, a total of 96,498 older adults succumbed to burn injuries in the United States. Analysis revealed a concerning increase in burn-related mortality rates from 2012 onwards. Demographic disparities were evident, with older men consistently exhibiting higher mortality rates compared to women. Racial disparities were observed, with Black individuals experiencing the highest mortality burden. Geographic analysis indicated elevated mortality rates in Western states and rural areas. Accidents emerged as the leading cause of death, with ischemic heart disease and hypertensive diseases being prevalent comorbidities. Complications, with septicemia being the most common, contribute significantly to mortality. ConclusionOur analysis of 20 years of burn-related mortality data from the CDC reveals alarming trends in the United States. Unlike global trends, mortality rates have stagnated from 1999 to 2020, indicating a persistent public health challenge. Black individuals aged over 65 bear the brunt of burn-related mortality, facing the highest age-adjusted rates among all racial groups. Regional disparities are stark, with states in the top 90 % exhibiting significantly higher age-adjusted mortality rates compared to those in the bottom 10 %. Moreover, rural areas consistently report higher mortality rates than urban areas. Ischemic heart disease, hypertensive diseases, and other heart-related conditions emerge as prevalent comorbidities. To effectively reduce burn-related injuries and fatalities, targeted public health policies are imperative. These interventions must prioritize high-risk populations and adopt culturally sensitive approaches to promote safety. Additionally, enhancing access to healthcare and fire safety education is vital for mitigating the burden of burn-related mortality among the elderly population.