Burn care in Los Angeles, California: LAC+USC experience 1994–2004

Garner, W.L.; Reiss, Matthew

doi:10.1016/j.burns.2004.10.002

Cited by 18 publications

(9 citation statements)

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“…[9,10,12,13,19] However, it is relatively similar to the mortality rates that have been reported from Iran. In a study by Soltani et al [20] conducted in Tehran, the mortality rate was 51% in males and 69% in females.…”

Section: Discussionsupporting

confidence: 59%

“…[6] According to previous reports from Iran, [7,8] the mortality rate of hospitalized burn patients is much higher than in developed countries. [9][10][11][12][13] As most of the introduced models have been designed based on data from developed countries, these models may not be fully compatible with the situation of burn care in developing countries like Iran. [14][15][16][17] To the best of our knowledge, there is no report from Iran to introduce a comprehensive model to predict mortality in hospitalized burn patients.…”

Section: Ocak -January 2011 Ulus Travma Acil Cerrahi Dergmentioning

confidence: 99%

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Factors associated with mortality in adult hospitalized burn patients in Tehran

Zarei

Dianat²,

Eslami³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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AMAÇYanığı takiben ortaya çıkan mortalite oranı, önemli bir sonuç parametresidir. Bu çalışmada, Tahran'da hastaneye yatırılan erişkin yanıklı hastalarda mortalite ile birlikte olan faktörlerin belirlenmesi amaçlandı. GEREÇ VE YÖNTEMBu çapraz karşılaştırmalı çalışma, Tahran'daki iki yanık başvuru merkezinde bir yıllık periyotta yapıldı. Çalışma periyodunda hastaneye yatırılan 1321 erişkin (>15 yaş) yanıklı hasta çalışmaya kaydedildi. Mortalite ile birlikte olan faktörleri belirlemek üzere, tek değişkenli analiz ve çok değişkenli (lojistik regresyon) analiz yapıldı. BULGULARHastaların ortalama yaşı 33,1±14,9 yıl idi. Yanıkların bü-yük çoğunluğu kazaya bağlıydı (n=1076, %81,5). Yanık mekanizması ile ilgili olarak, petrol ürünleri ile en sık yanık nedeni idi. Ortalama yüzde yanık toplam vücut yü-zey alanı (TVYA) %39,9±%25,8 idi. Mortalite oranı %33 oldu. Sepsis, en sık mortalite nedeniydi. Bu çalışmanın sonuçlarına göre erişkin yanık hastalarında iş kazası olmayan yanıklar, yanık olan TVYA ve ikinci ve üçüncü derece yanıktan etkilenmiş yüzey alanı mortalitenin bağımsız belirleycileridir. SONUÇBu çalışma, çalışılan yanık merkezlerinde yüksek bir mortalite oranı olduğunu göstermiştir. Belirlenen risk faktör-leri olan hastalar, yatışları sırasında yüksek riskli hastalar olarak sınıflandırılmalı ve bu hastalara hastanede kalış sü-resince özel ilgi ve bakım gösterilmelidir.Anahtar Sözcükler: Yanık; İran; mortalite, risk faktörü; toplam vü-cut yüzey alanı.

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Section: Discussionsupporting

confidence: 59%

Section: Ocak -January 2011 Ulus Travma Acil Cerrahi Dergmentioning

confidence: 99%

Factors associated with mortality in adult hospitalized burn patients in Tehran

Zarei

Dianat²,

Eslami³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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“…There have been several prior reviews of burn injury demographics, prevention, and care since the mid-1990s [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]. However, most were either focused on a select patient cohort or outcome, were discontinuous in time, or covered a relatively short time span.…”

Section: Introductionmentioning

confidence: 99%

Harborview Burns – 1974 to 2009

et al. 2012

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BackgroundBurn demographics, prevention and care have changed considerably since the 1970s. The objectives were to 1) identify new and confirm previously described changes, 2) make comparisons to the American Burn Association National Burn Repository, 3) determine when the administration of fluids in excess of the Baxter formula began and to identify potential causes, and 4) model mortality over time, during a 36-year period (1974–2009) at the Harborview Burn Center in Seattle, WA, USA.Methods and Findings14,266 consecutive admissions were analyzed in five-year periods and many parameters compared to the National Burn Repository. Fluid resuscitation was compared in five-year periods from 1974 to 2009. Mortality was modeled with the rBaux model. Many changes are highlighted at the end of the manuscript including 1) the large increase in numbers of total and short-stay admissions, 2) the decline in numbers of large burn injuries, 3) that unadjusted case fatality declined to the mid-1980s but has changed little during the past two decades, 4) that race/ethnicity and payer status disparity exists, and 5) that the trajectory to death changed with fewer deaths occurring after seven days post-injury. Administration of fluids in excess of the Baxter formula during resuscitation of uncomplicated injuries was evident at least by the early 1990s and has continued to the present; the cause is likely multifactorial but pre-hospital fluids, prophylactic tracheal intubation and opioids may be involved.Conclusions1) The dramatic changes include the rise in short-stay admissions; as a result, the model of burn care practiced since the 1970s is still required but is no longer sufficient. 2) Fluid administration in excess of the Baxter formula with uncomplicated injuries began at least two decades ago. 3) Unadjusted case fatality declined to ∼6% in the mid-1980s and changed little since then. The rBaux mortality model is quite accurate.

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“…The biographical details of the cohort were found to be consistent with Australian and worldwide reported population data in respect to age and gender distribution, injury etiology, % TBSA affected, and location of injury. [23][24][25][26][27][28][29][30] …”

Section: Participant Populationmentioning

confidence: 99%

Incidence and Predictive Factors for Dysphagia After Thermal Burn Injury: A Prospective Cohort Study

Rumbach

Ward

Cornwell

et al. 2011

Journal of Burn Care & Research

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The objective of this study is to determine dysphagia incidence for a consecutively admitted population of thermal burn injury patients and to determine admitting characteristics that can be used to reliably predict patients at risk of developing dysphagia after thermal burn. Four hundred thirty-eight patients with thermal burns, with or without inhalation injury, who were consecutively admitted to and received management at a state-wide burn center over a 2-year period (2007-2009) were included. All patients meeting the project's inclusion criteria underwent clinical swallowing assessment to determine the presence or absence of dysphagia. Dysphagia incidence was found to be 11.18% (n = 49) in the admitted population. Dysphagia severity at initial assessment was classified as severe for 40.82%, moderate for 30.61%, and mild for 28.57%. Statistical analysis revealed a core set of statistically significant parameters known within the first 24 hours postinjury that showed strong sensitivity and specificity for detection of dysphagia risk. These include, in isolation or in combination, with the consideration of increasing age, TBSA burnt ≥18%, head and neck burns, need for escharotomy, inhalation injury, need for intensive care admission, and need for mechanical ventilation. This is the first large, prospective cohort study to document dysphagia incidence within the thermal burn population and to validate key predictors for dysphagia risk in this population. These data will assist the allocation and planning of speech pathology services and provide an evidence-based pathway for ensuring early identification and management of patients at high risk of dysphagia after thermal burn injury.

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Burn care in Los Angeles, California: LAC+USC experience 1994–2004

Cited by 18 publications

References 0 publications

Factors associated with mortality in adult hospitalized burn patients in Tehran

Factors associated with mortality in adult hospitalized burn patients in Tehran

Harborview Burns – 1974 to 2009

Incidence and Predictive Factors for Dysphagia After Thermal Burn Injury: A Prospective Cohort Study

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