Factors affecting survival in adult patients with massive burns

Yan, Wang; Tang, Haihong; Xia, Zhaofan; Zhu, Shan; Ma, Bing; Wei, Wenli; Sun, Ying; Lv, Kaiyang

doi:10.1016/j.burns.2009.04.014

Cited by 50 publications

(37 citation statements)

References 18 publications

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“…In addition, burn size, severe inhalation injury, serum creatinine, inotropic support, thrombocytopenia, sepsis, and ventilator dependency have been reported as associated factors for mortality. [13] Al et al have found that in addition to some other parameters, hypoalbuminemia and sepsis are important factors for mortality. [14] Brusselaers et al reported in a systematic review of the severe burn injuries in Europe from 1985 to 2009 that burn size and age were the main factors associated with mortality.…”

Section: Discussionmentioning

confidence: 99%

Mortality risk factors in burn care units considering the clinical significance of acinetobacter infections

Atilla¹,

Tomak²,

Katrancı³

et al. 2015

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

Mortality risk factors in burn care units considering the clinical significance of acinetobacter infections

Atilla¹,

Tomak²,

Katrancı³

et al. 2015

Ulus Travma Acil Cerrahi Derg

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“…In the CBC test, thrombocytosis is used as a marker of acute phase reaction. However, thrombocytopenia (TP) has recently been recognized as a prognostic marker in a variety of acute and critical diseases, including H1N1 influenza [7], community acquired pneumonia [8], acute kidney injury [9,10], burns [11,12], as well as in both pediatric and adult critically ill patients [13,14]. TP may reflect some pathophysiologic disturbances, including disseminated intravascular coagulation, sepsis, macrophage activation, vitamin deficiencies, drug-induced toxicity, and unidentified factors [14].…”

Section: Introductionmentioning

confidence: 99%

Thrombocytopenia as a Marker of Outcome in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Rahimi-Rad

Soltani

Rabieepour

et al. 2015

Advances in Respiratory Medicine

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Introduction: Thrombocytopenia (TP) is associated with poor outcome in patients who are critically ill with pneumonia, burns, and H1N1 influenza. To our knowledge, no similar study in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has been conducted to date. The aim of this study was to determine the impact of platelet count on the outcome of patients with AECOPD. Material and methods: Patients admitted to our teaching hospital for AECOPD were divided into two cohorts, those with and without TP. The outcome of all patients was followed. Results: Of the 200 patients with AECOPD, 55 (27.5%) had TP. Of these, 14 (25.5%) died in the hospital, whereas of the 145 non-TP patents, 11 (7.5%) died (p-value = 0.001). There was a significantly higher transfer rate to the ICU and mechanical ventilation in TP patients. The mean platelet count was significantly lower in patients who died than those who were discharged (161,672 vs. 203,005 cell/µL; p-value = 0.017). There was negative correlation between duration of hospitalization and platelet count. Conclusion: TP was associated with poor outcome in AECOPD. TP could be considered as a marker for the assessment of inflammation and prognosis in AECOPD patients based on its cost-effective features.

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“…Other studies have identified independent predictors of mortality that include sepsis, ventilator dependency, and low platelet counts. 13 Although many of these limitations were because of the lack of proper infrastructure or expensive monitoring devices, certain inexpensive improvements may have improved care such as point-of-care hemoglobin monitoring, glucometry, better urine output monitoring, supplemental oxygen machines, and bedside pulse oximetry. Finally, an operating theater dedicated to burn care would also have improved outcomes.…”

Section: Discussionmentioning

confidence: 99%

Responding to Major Burn Disasters in Resource-Limited Settings: Lessons Learned From an Oil Tanker Explosion in Nakuru, Kenya

Kooij

Schrever

Kizito

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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Background: On January 31, 2009, a fuel tanker exploded in rural Kenya, killing and injuring hundreds of people. This article describes the care of Ͼ80 burn victims at a rural hospital in Kenya, Nakuru Provincial General Hospital, and provides lessons for care of a large number of burned patients in a resource-limited setting. Methods: Data were obtained from retrospective review from hospital registers and patient files. Results: Treatment was provided for 89 victims. Eighty-six (97%) were men; median age was 25 years (interquartile range [IQR],[19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Half of the patients (45) died, the majority (31, 69%) within the first week. The median total body surface area burned for those who died was 80% (IQR, 60 -90%) compared with 28% (IQR, 15-43%) for those who survived (p Ͻ 0.001). Twenty patients were transfused a total of 73 units of blood including one patient who received 9 units. Eighty surgical interventions were performed on 31 patients and included 39 split-thickness skin grafts, 21 debridements, 7 escharotomies, 6 dressing changes, 4 contracture releases, and 3 finger amputations. Of the 44 survivors, 39 (89%) were discharged within 4 months of the event. Conclusions: Mortality after mass burn disasters is high in Africa. In areas where referral to tertiary centers is not possible, district hospitals should have mass disaster plans that involve collaboration with other organizations to augment medical and psychologic services. Even for patients who do not survive, compassionate care with analgesics can be given.

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Factors affecting survival in adult patients with massive burns

Cited by 50 publications

References 18 publications

Mortality risk factors in burn care units considering the clinical significance of acinetobacter infections

Mortality risk factors in burn care units considering the clinical significance of acinetobacter infections

Thrombocytopenia as a Marker of Outcome in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Responding to Major Burn Disasters in Resource-Limited Settings: Lessons Learned From an Oil Tanker Explosion in Nakuru, Kenya

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