Multiple Organ Failure as a Cause of Death in Patients With Severe Burns

Abstract

The aim of this study was to investigate the causes of death in patients with burns using both medicolegal autopsy reports and clinical data collected during treatment to specify irreversible organ dysfunctions leading to death. Burn deaths occurring in the Helsinki Burn Center from 1995 to 2005 were identified in the hospital database. The clinical charts and medicolegal autopsy reports were retrieved and compared. The data were evaluated by plastic surgeons specialized in burn care, an intensivist, and a pathologist, with special reference to organ-specific changes in the autopsy reports. From 1999 to 2005, there were 71 burn deaths in the Helsinki Burn Center of which 40% was caused by multiple organ failure (MOF). Death from untreatable burn injury was recorded in 28 patients, whereas other causes were scarce. MOF patients displayed approximately four organ failures on average, ranging from three to eight. All 28 MOF patients were recorded to have acute renal failure, followed by liver damage, of which four patients had acute or chronic liver failure. Sepsis was always affiliated with MOF as a cause of death. In conclusion, careful examination of MOF as a cause of death revealed several organ failures: four organ failures per patient. Acute renal failure was noted in all MOF patients. Sepsis was always affiliated with MOF.

The utility of C-reactive protein and procalcitonin for sepsis diagnosis in critically burned patients: A preliminary study

“…This enhances the appearance and proliferation of multiresistant bacteria and increases costs. Conversely, failure to apply early and appropriate antibiotic treatment for suspected infection is widely demonstrated to be associated with a worse prognosis in all patient groups (5)(6)(7)21). Therefore, the incorporation of PCT analysis, as an objective biomarker of infection in burn patients, would lower antibiotic exposure, reduce unneeded rotations of vascular access, and decrease the number of requested microbiological determinations, both invasive and noninvasive.…”

Outcome of burn care : the mortality perspective

“…62 The principal causes of death in Sweden are cardiovascular disorders and cancer 100 and, among those with burns, multiple organ failure. 101,102 In our third study, we showed that the causes of death in most patients who died with a low Baux score were not directly related to the burn, and therefore they cannot be predicted by models of burn-specific mortality.…”

Comparison of antemortem clinical diagnosis and postmortem findings in burn-related deaths

“…[1,3,9,10] In developed countries, on the other hand, such deaths are more common among children and the elderly. [7,11] This age difference can be explained by the implementation of more effective preventive measures and greater availability of treatment options in developed countries.…”

“…[6] The comparison of antemortem and postmortem findings has revealed differences between antemortem clinical diagnoses and autopsy findings. [6][7][8] Autopsy may show unexpected or unrecognized clinical findings, and the data obtained from autopsy can be used to elucidate future problems experienced by the patients.…”