Burn Injury Mortality Research Articles

Burn Injuries From TikTok Challenges: A Brief Report.

Social media (e.g., TikTok) challenge is a relatively new phenomenon wherein a user creates and posts videos performing an often-dangerous task. The ease of access and availability of social media in recent times make teens and young adults susceptible to these viral Internet challenges and accidental injury. The severity, morbidity, and mortality of burn injuries from social media challenges have not readily been documented in the medical literature. In this brief report, we present three cases of accidental burns after attempting social media challenges involving boiling water or flame. The injuries ranged from superficial partial thickness burns to 24% total body surface area (TBSA) full thickness burns. Online challenges show the potential for severe injury and disability and underlie the importance of awareness and education of the public, further research into the usage of TikTok and other media platforms, and early referral to the American Burn Association recognized center.

Role of Ryan Score in Predicting Mortality in Thermal Burns

Burn injuries can present in a myriad of ways and in a diverse patient population. Its severity is not only determined by the nature of the burn injury or the extent of the injury but also by several patient factors. Mortality in burn injury used to be very unpredictable but now there are various means of predicting morbidity and mortality in a burns patient. The scoring system developed by Ryan Score was one such tool formulated to aid in outcome prediction in burn patients. In this case study, we evaluate the accuracy of the Ryan score in predicting mortality outcomes in a patient with thermal burns.

The predictive probability of mortality in the presence of full-thickness burns

IntroductionPrognostication of burn injury mortality is challenging. Recent mortality prognostication tools have incorporated the percent of full-thickness surface area (FTSA). We hypothesize that the presence of full-thickness burn injury independently increases in-hospital mortality. MethodsWe performed a retrospective review of the National Trauma Data Bank (NTDB) from 2007 to 2019 of adults (≥16 years old) with burn injuries. Variables evaluated included basic demographics, presence of inhalation injury, percent TBSA, and percent FTSA burned. The primary outcome was in-hospital mortality. We performed modified Poisson regression modeling adjusting for significant variables to estimate the relative mortality risk. Results75,816 patients met inclusion criteria. When controlling for TBSA, the presence of a full-thickness burn had a relative risk of in-hospital mortality of 1.42 (95% CI 1.09–1.85, p = 0.008). The predicted probability of mortality was 100% at 50% FTSA. ConclusionThe presence of full-thickness burns and the proportion of full-thickness burns independently and significantly increased in-hospital mortality. Therefore, clinicians should utilize prognostication models incorporating percent full-thickness burn area to predict mortality more accurately.

Epidemiology and outcome analysis of 1359 intensive care burn patients: A 14-year retrospective study in a major burn center

AimsGlobally, burn-related morbidity and mortality still remain high. In order to identify regional high-risk populations and to suggest appropriate prevention measure allocation, we aimed at analyzing epidemiological characteristics, etiology and outcomes of our 14-year experience with an intensive care unit (ICU) burn patient population. MethodsA retrospective observational study was conducted including patients treated between March 2007 and December 2020 in our intensive care burn unit. Demographic, clinical and epidemiological data were collected and analyzed. ResultsA total of 1359 patients were included. 68% of the subjects were males and the largest age group affected entailed 45–64-year-old adults (34%). Regarding etiology, flame and contact burns were the most common in all age groups. Mean affected total body surface area (TBSA) was 13 ± 14.5% in all subjects. Most of the burns occurred domestically or during recreational activities. Mean hospital stay was 17.77 ± 19.7 days. The average mortality was 7.7%. The mortality rate showed an overall decreasing trend whilst burn severity remained consistent from 2007 to 2020. ConclusionsDespite consistent burn severity presentations of annual ICU admissions, burn injury mortality showed a decreasing trend, which was in part attributed to substantial progress in burn care and treatment and improved burn prevention awareness. Statistically significant age and gender differences could be detected with regard to burn etiology and seasonality, as well as outcomes, which highlight the importance of individualized primary prevention programs.

Mortality and Years of Life Lost due to Burn Injury Among Older Iranian People; a Cross-Sectional study

Introduction:The mortality of burn injury is a serious health problem among older people. The present study aimed to determine the epidemiological characteristics of burn mortality and Years of Life Lost (YLLs) among people aged ≥ 60. Methods:The National and Subnational Burden of Disease (NASBOD) study includes population-based cross-sectional data from the death registration system of Iran and those recorded by the cemeteries of Tehran and Esfahan were used in this study. Spatio-temporal and Gaussian process regression models were applied to estimate rates and trends of mortality and cause-specific mortality fractions. YLLs were calculated using Iranian life expectancy and the number of deaths. Results:The mortality rate for 1990 and 2015 was 17.4 and 4.5 per 100,000, respectively. From 1990 through 2015, the annual percentage of change in burn mortality rate was -6.1% in females and -4.4% in males. During 2015, there were 326 deaths following burns in people aged 60+ with 4586 person YLLs, and in 1990 there were 523 deaths with 4862 person-YLLs. The male-female ratio for 1990 and 2015 were 0.80 and 0.88, respectively. The age-standardized mortality rate was higher than 8.5 per 100,000 in border provinces in 2015. The provinces with better socioeconomic situations, such as Tehran, had a lower mortality rate than poor provinces, such as Sistan va Baluchistan.Conclusion:Although burn mortality in old people decreased in those 26 years, it is still high compared to high-income countries. Continued efforts to increase preventive measures and adequate access to quality care, especially in border provinces, is suggested.

Hyperbaric Oxygen and Mortality in Burns With Inhalation Injury: A Study of the National Burn Repository.

Mortality in burn injury is primarily influenced by three factors: age, percent burn (%TBSA), and presence of inhalation injury. Numerous modalities have been tried in an attempt to treat those patients with burns and inhalation injury, including the use of hyperbaric oxygen (HBO). The aim of our study was to find the national prevalence of HBO for burns with inhalation injury, and whether HBO influenced mortality in these often severely injured patients. This retrospective study used the National Burn Repository (NBR) to identify hospital admissions of patients with both cutaneous burn and inhalation injuries. After applying exclusion criteria, a total of 13,044 patients were identified. Variables included in the multivariate regression analysis included age, sex, race, payer, mechanism of burn injury, TBSA group, total procedure number, mechanical ventilator days, and treatment with HBO. The main outcome variable was mortality. Of the 13,044 patients, 67 had HBO therapy. The HBO patients were older (mean age 51.7 vs 42.8 years, P < .001), but had smaller burns and thus a similar Baux score (66.6 vs 65.2, P = .661). The HBO patients had a higher mortality (29.9% vs 17.5%, P = .01). On multivariate regression analysis, HBO was an independent predictor of mortality (odds ratio = 2.484, P = .004). Other significant predictors of mortality included age, black race, Medicaid or uninsured patients, and %TBSA. The use of HBO for patients with burns and inhalation injury is uncommon in this database. It is unclear whether that reflects low prevalence or if individual centers do not all impute HBO into the NBR. For those patients in this database, HBO is an independent predictor of mortality. It can be difficult to determine the severity of inhalation injury in the NBR, so those patients receiving HBO could theoretically have more severe inhalation injury.

Experience with Burn Prevention Program in North Eastern India

Burn injuries are one of the most devastating of all injuries and a major global public health concern. Though burn injuries cause lots of morbidity and mortality in India, community-based interventions in the forms of multi-strategic and multi-focused preventive programs are however lacking. This study, undertaken in the North Eastern Indian state of Assam, aims at reducing the incidence of burn accidents, morbidity and mortality of burn injuries through focused attention towards sensitizing the community with well-structured preventive program. Participatory community seminars, use of print, electronic and social media and lectures and demonstrations in schools were the tools used in the preventive programs. Analysis of inpatient and outpatient records of burn injured patients treated in the burn unit and scoring system in school education program and social media participants helped in assessment of the impact of Burn Preventive Programs (BPP). For convenience of assessment, comparative analysis of the results in early (Block I) and later part (Block II) of the study period was made. Results showed significant reduction of percentage of patients reporting from the areas where BPP was implemented. There was also reduction in %TBSA burn in majority patients in Block II in comparison to Block I. Water was used to extinguish fire in 48.9% patients in Block I and 78.0% patients in Block II. Water was also used to cool burn wounds by 52.3% patients in Block I, and 83.4% patients in Block II. While 80.9% people made inappropriate topical application on the wounds in Block I, only 34.6% did so in Block II. Increased awareness amongst general people was reflected by increased percentage of patients reporting to burn unit within 7 hours of injury and significant reduction of firecracker burns from 21.9% (Block I) to 7.8% (Block II). Similarly, improved awareness amongst the students was evident from the improved scoring by majority students and reduction in burns amongst them in the later part of Block II. The results indicate that BPP has got positive impact in the society.

Burn Care in the Greek and Roman Antiquity.

The last century brought about more rapid new developments in the treatment of burns, which significantly lowered the mortality of burn injuries. However, burns were already treated in antiquity, where the threshold from spirituality to scientific medicine originated. The existing literature on burn treatment is very limited and there are many cross-references, some of them incorrect. The aim of this work by an interdisciplinary team of historians and physicians is to offer a more precise reproduction of the burn treatment of Greek and Roman antiquity using original texts in context and with a modern scientific background. There are many sources from ancient doctors on the subject of burn treatment, as well as the treatment of burned-out wounds and frostbite, which have not yet been mentioned. The literature research also showed an understanding of scientific contexts in ancient medicine, such as antiseptics or rheology. Interestingly, there was a change in burn medicine from everyday Greek medicine to Roman military medicine with other burn patterns. The care of patients using analgetics and the therapy of burn shock arose from the literature. The ancient world is considered to be the foundation of medicine, but it is believed to have been based mainly on shamanism rather than science. However, already more than two millennia ago, burns were correctly assessed and treated according to today’s scientific standards and scientific relationships were recognized.

Trends in burn injury mortality in Spain (1979–2018): Sex-specific age-cohort-period effects

BackgroundPrevious studies about burns mortality are often exclusively based on hospital and burn centre data. National population-based reports on this topic are rather limited. The aim of this study was to analyse sex- and age-specific mortality rates of burns in Spain during the period 1979–2018. MethodsAge-standardised burns mortality rates were calculated from death records and mid-year population data were provided by the Spanish National Statistics Institute. Joinpoint regression analyses were used to identify significant points of change in trends over time and to compute average annual per cent change (AAPC). Age, period and cohort effects were also analysed. ResultsMortality due to burn injury decreased in both sexes between 1979 and 2018: from the first quinquennium of this period up to the last one age-adjusted mortality rates decreased from 1.37 to 0.49 per 100,000 in men and from 0.96 to 0.26 per 100,000 in women. ConclusionsBurns mortality rates in Spain have been decreasing during the last decades. Promotion of primary prevention measures should continue.

Potential combinations of Platelet Rich Plasma (PRP) and chitosan in burn wound management: a review

Background:Â The development of new modality for burn wound healing is necessary to reduce morbidity and mortality of burn injury. PRP (Platelet Rich Plasma) is one of potential modality for burn injury because of its ability to deliver various growth factors to initiate and accelerate tissue healing and regeneration. Clinical efficacy of PRP is frequently disturbed because inconsistency and inefficiency of growth factor release in PRP. To increase the effectiveness of PRP in wound healing and increase the bioavailability of growth factor, PRP can be combined with a carrier that can control continuous release of growth factors. Chitosan is one of biomaterial that potential to use because of its biodegradability characteristic and biological activity that important for burn wound healing and prevent the formation of scar tissue in a burn injury. Researches have shown that chitosan is an effective carrier to facilitate growth factor release continuously to burn wound.Aims: This review aims to review potential Combinations of PRP (Platelet Rich Plasma) &amp; Chitosan in Burn WoundConclusion:Â With chitosan ability to facilitate burn wound healing and as an effective carrier, combination of PRP and chitosan is a promising modality for burn wound healing.

The effect of traditional healer intervention prior to allopathic care on pediatric burn mortality in Malawi

IntroductionBurn injury is a significant contributor to mortality, especially in low and middle-income countries (LMICs). Patients in many communities throughout sub-Saharan Africa use traditional health practitioners for burn care prior to seeking evaluation at an allopathic burn center. The World Health Organization defines a traditional health practitioner as “a person who is recognized by the community where he or she lives as someone competent to provide health care by using plant, animal and mineral substances and other methods based on social, cultural and religious practices based on indigenous knowledge and belief system.” The aim of this study is to determine the prevalence of prior traditional health practitioner treatment and assess its effect on burn injury mortality. MethodsA retrospective analysis of the prospectively collected Kamuzu Central Hospital (KCH) Burn Surveillance Registry was performed from January 2009 through July 2017. Pediatric patients (<13 years) who were injured with flame or scald burns were included in the study and we compared groups based on patient or family reported use of traditional health practitioners prior to evaluation at Kamuzu Central Hospital. We used propensity score weighted multivariate logistic regression to identify the association with mortality after visiting a traditional healer prior to hospitalization. Results1689 patients were included in the study with a mean age of 3.3 years (SD 2.7) and 55.9% were male. Mean percent total body surface area of burn was 16.4% (SD 12.5%) and most burns were related to scald injuries (72.4%). 184 patients (10.9%) used traditional medicine prior to presentation. Only a delay in presentation was associated with prior traditional health practitioner use. After propensity weighted score matching, the odds ratio of mortality after using a prior traditional health practitioner was 1.91 (95% CI 1.09, 3.33). ConclusionThe use of traditional health practitioners prior to presentation at a tertiary burn center is associated with an increased odds of mortality after burn injury. These effects may be independent of the potential harms associated with a delay in definitive care. Further work is needed to delineate strategies for integrating with local customs and building improved networks for burn care, especially in rural areas.

Trends of Burn Injury in the United States: 1990 to 2016.

The aim of this study is to report patterns of burn injury within the United States from 1990 to 2016 with regard to age, sex, geography, and year. Advances in the management of burn injuries as well as successful public health efforts have contributed to reductions in the annual incidence and mortality of burns. However, several studies suggest that these reductions are not equally distributed throughout the US population. The Global Burden of Disease Study 2016 was utilized to collect incidence, mortality, disability-adjusted life years (DALYs), and years lived with disability (YLD) from 1990 to 2016. All measures were computed with 95% uncertainty intervals (UI). The overall incidence of burn injury in the United States has decreased from 215 (95% UI, 183-246) to 140 (95% UI, 117-161) per 100,000. However, the relative mortality of burn injury has been fixed over the 26-year study period. Alaska had the highest rates of burn incidence in 1990 and 2016, closely followed by southeastern states. When adjusted for incidence, relative mortality in 1990 was highest in Alabama and Mississippi and the mortality-incidence ratio increased for these states in 2016. In addition, 35 states also demonstrated an increase in the relative mortality of burn injury during the study period. Regional trends of burn incidence and mortality are highly variable and are likely due to a multitude of factors. Addressing these disparities will require close examination of the contributing factors of burn injury and severity.

The Bacteriological Profile of Burn Wound Infections at a Tertiary Burns Center in Nepal.

In Nepal, burn is the third most common injury after falls and road traffic accidents. Infection is the leading cause of mortality in burn injury. A profile exploring predominant flora and antimicrobial sensitivity is important to facilitate treatment ahead of microbiology results and to aid prevention of multidrug-resistant organisms. The aim of this study was to document epidemiological and bacteriological data of burn wound infections at a tertiary level burns center in Nepal. Samples were collected from January 2017 to May 2017, over a period of 5 months. Patient notes were referred to and information regarding baseline characteristics and burn wound infection data was collected. A total of 76 patients were included in the study during the 5-month period, which resulted in 113 samples being included for review. Females were injured most with burns 70% (n = 53) compared with males 30% (n = 23). Only 6 (8%) of 77 patients lived locally in Kathmandu. The average distance traveled by patients was 233 km (median 208, range 0-765, SD 181). Average TBSA% of burn was 22% (median 20, range 3-50, SD 12). Gram-negative organisms predominated, with Acinetobacter spp. in 42 cases (55%), Pseudomonas aeruginosa in 26 cases (34%), and Enterobacter spp. in 16 cases (21%). Colistin, polymyxin B, and tigecycline were found to be most sensitive covering 108, 98, and 94 organisms. Gram-negative bacteria colonized the majority of burn wounds. Colistin, polymyxin B, and tigecycline were the most sensitive to gram-negative bacteria. Gram-positive Staphylococcus aureus was sensitive most to vancomycin and tigecycline.

Epidemiology and Mortality of Burn Injuries in Eastern Iran Since 2009: An analysis of 2115 Cases

Background: Historically, burn injuries have been accompanied by bad prognosis. With the advances in recovering fluids and the early excision of burn scars, the survival rate has increased for severe burn patients. Objectives: The study aimed to analyze the epidemiology of burn injuries in Zahedan, Eastern Iran. Patients and Methods: This retrospective study examined 2173 burn patients for eight years. The research data were extracted from patients’ files and analyzed by SPSS 22 using the chi square test, t test and ANOVA. Results: In sum, out of 2173 files, 2115 files were analyzed. About two-thirds (71%) of burns were due to flame, one-fifth (21.2%) to boiling water, and 8% to other means. There was a significant relationship between patients’ age, gender, burn percentage, burn degree, burn cause, burn occurrence season, hospitalization duration, and addiction or non-addiction status with rate of death (P < 0.001). Conclusions: In this region of Iran, burn is influenced by families’ culture, economy, urban service level, workplace, home heating devices, type of people’s clothing, and awareness. The statistical analysis of the existing data completely indicated the epidemiology of burns in Eastern Iran.

Burn injury mortality in patients with preexisting and new onset renal disease

IntroductionWe sought to examine the impact of preexisting and new onset renal disease on burn injury mortality. MethodsRetrospective analysis of patients admitted to a regional burn center from 2002-2012 was performed. Variables analyzed included demographics, burn mechanism, inhalation injury status, and % TBSA. Poisson regression was performed to estimate risk of in-hospital burn mortality. ResultsThere were a total of 7640 patients over the study period. The adjusted 60-day risk of in-hospital mortality in patients with preexisting renal disease (PRD was 3 times higher compared to patients with no preexisting renal disease (IRR = 3.22, 95% CI = 1.26–8.25). The adjusted 60-day risk of mortality is 2 times higher for patients with new onset renal disease compared to those without (IRR = 2.11, 95% CI = 1.55–2.87). ConclusionPreexisting and new onset renal disease results in a significantly higher risk of mortality following burn injury compared to patients without renal disease. Prevention of new onset renal injury and careful management of patients with preexisting renal disease to prevent exacerbation should be pursued.

Lethal Area 50 in Patients with Burn Injuries in North West, Iran.

Introduction: In view of their considerably high rates of mortality and morbidity, burns are still viewed as one of the most important health-threatening environmental hazards imposing a significant burden on the health care system in low and middle-income countries. This study seeks to determine the lethal area fifty percent (LA50) in all burn patients admitted over a period of five years and the factors influencing mortality in burn injuries. Methods: This study was a cross-sectional carried out from 2010 to 2014 in Sina Hospital of Tabriz, 1226 participant including 319 women, 346 men, 272 girls, and 289 boys were selected through stratified sampling. The demographic and clinical data of patients ( their age, gender, burn type, TBSA, the season and consequences of burning) were all extracted and then analyzed, using descriptive statistics (measures of central tendency and variability) and inferential statistics(chi-square and linear regression)at a significance level of 0.05. The LA50 was calculated through determining the relationship between the total body surface area and mortality rate (The extent of the body burns measured and recorded based on Lando Chart in hospitals). Results: The highest (47.6%) and the lowest (3.8%) rates of burns were observed among those aged below 16 and above 65, respectively. The majority of the participants were residents of cities (55.4%), married (34.6%), illiterate (56.6%), and housewives (14.8%). Most burns were caused by accidents (98.4%) at home (90.6%). Most patients had suffered first- and second-degree burns (68.4%), with no inhalation damages (99.5%). Hot liquids were the main culprit in most of the burns (58.7%) and the upper extremities were the most frequently affected areas (34.8%). There was .99 rise in mortality for every percent increase in TBSA, and there seemed to be a significant relationship between the age level and the eventual outcome- the higher the age, the more likely for the incident to end in death.LA50 was also determined 43.73 percent for five years. Finally, the study findings showed that female gender, TBSA and age are associated with death from burn. Conclusion: Given the high LA50 index at this center, it is of high priority in our country to enhance the public knowledge and the quality of the care provided for the burn patients. Patients at risk including women, children, elderly and extensive burns should be considered.

Prognostic factors affecting the mortality of 2nd and 3rd degree burn injuries at a tertiary care center in Indonesia

About two million people suffer from burn injuries in the United States each year, with 100,000 hospitalized in the burn unit. Around 1000 patients suffer from severe burn injuries, with each year average of 300 deaths. Improvements in the understanding of the prognostic factors affecting burn injuries over the past decades have led to advances in medical and surgical treatment. However, comprehensive data on the factors affecting burn injuries in Indonesia have not been available, yet. The aim of the study was to investigate the prognostic factors affecting the mortality of 2nd and 3rd burn injuries patients in Dr. Sardjito General Hospital, Yogyakarta. This was a cross-sectional study conducted within the period of 2007-2011 using secondary data from the Department of Medical Records. Chi-square and logistic regression analysis were used to evaluate the correlation between the prognostic factors and the mortality. A p value 0.05). Furthermore, patients with albumin level 50%, inhalation trauma and hospitalized in 24 hours after the incident were at 22.98, 7.65, 3.0 and 4.59 times higher risk of mortality, respectively (p<0.05). In conclusion, albumin level, burn injury percentage, inhalation trauma and time of arrival are prognostic factors affecting the mortality of the burn injuries patients.

Burn injury mortality in patients with preexisting and new onset renal disease

Burn injury mortality in patients with preexisting and new onset renal disease

Sex Differences in Burn Injury Mortality: A Propensity Score Analysis

Knowlin, Laquanda MD; Cairns, Bruce A. MD, FACS; Charles, Anthony G. MD, MPH, FACS Author Information

Measured Effect Magnitude of Comorbidities on Burn Injury Mortality

Measured Effect Magnitude of Comorbidities on Burn Injury Mortality