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Background Burn outcomes can be improved by reducing mortality and hospital admission duration. This increases patient quality of life and reduces hospital‐associated complications and costs. This study aimed to develop a model with which to predict burns inpatient mortality and admission duration. Methods Multiple logistic and linear regression were used to investigate mortality and admission duration by age, total body surface area, sex, delay to presentation, the use of surgery, discharge distance and period. Results One thousand four hundred and seventy nine patients (747 pre‐COVID and 732 during COVID) were admitted between the study dates. Using multiple logistic regression, age and total body surface area predicted mortality LR X2 (5), P < 0.001, pseudo R2 = 0.57. Using multiple linear regression, age, total body surface area and the use of surgery predicted admission duration F (7, 1455) = 161.42, P < 0.001, R2 = 0.44. Sex, delay to presentation, period and discharge distance did not predict mortality or admission duration. Conclusions In our institution, mortality was increased by 8.6% for each additional year of age and by 11.3% for each additional percentage total body surface area. Likewise, admission duration was prolonged by 1 day for every 7 years of increased age, by 1 day for each additional percentage total body surface area or by 7 days if surgery was required. These models have been incorporated into a set of prediction tables for mortality and admission duration for use in our institute that can guide patient and family discussions.

Acquired tracheoesophageal fistulae are uncommon in burn patients but can occur as a complication of inhalation injury. We report a case of a 30-year-old male patient presenting after suffering from inhalation and 25% total body surface area burns. On post burns day 14 he developed a massive tracheoesophageal fistula causing refractory acute respiratory failure. Veno-venous extracorporeal membrane (VV ECMO) oxygenation was initiated without systemic anticoagulation via bi-femoral cannulation under transthoracic echocardiography guidance. He underwent successful 5-hour apnoeic ventilation-assisted surgical repair of the fistula via a right posterolateral thoracotomy. ECMO was discontinued after 36 hours, and he was discharged to the ward after 33 days in the intensive care unit. Inhalation burn injury can cause a delayed life-threatening tracheoesophageal fistula. Surgical repair can be successfully performed for this condition. VV- ECMO can be used to facilitate prolonged apnoeic surgery and to manage refractory respiratory failure due to this condition.

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