Review of Adult Electrical Burn Injury Outcomes Worldwide

Abstract

Objective To review low-voltage versus high-voltage electrical burn complications in adults, and to identify novel areas that are not recognized to improve outcomes. Methods An extensive literature search on electrical burn injuries was performed using OVID Medline, PubMed and EMBASE databases from 1946–2015. Studies relating to outcomes of electrical injury in the adult population (≥18 years of age) were included in the study. Results Forty-one single-institution publications with a total of 5485 electrical injury patients were identified and included in the present study. 18.0% of these patients were low-voltage injuries (LVI), 38.3% high-voltage injuries (HVI) and 43.7% with voltage not otherwise specified (NOS). Forty-four percent of studies did not characterize outcomes according to low versus high-voltage injuries. Reported outcomes include surgical, medical, post-traumatic, and other (long-term/psychological/rehabilitative), all of which report greater incidence rates in HVI compared to LVI. Only two studies report on psychological outcomes such as post-traumatic stress disorder. Mortality from electrical injuries are 2.6% in LVI, 5.2% in HVI and 3.7% in NOS. Coroner’s reports reveal a ratio of 2.4:1 for deaths caused by low-voltage injury compared to high voltage-injury. Conclusions High-voltage injuries lead to greater morbidity and mortality than low-voltage injuries. However, the results of the coroner’s reports suggest that immediate mortality from low-voltage injury may be underestimated. Furthermore, based on the data of this analysis we conclude that the majority of studies report electrical injury outcomes, however, the majority of them do not analyze complications by low versus high voltage and often lack long-term psychological and rehabilitation outcomes post-electrical injury indicating that a variety of central aspects are not being evaluated or assessed.

Electrical injury – a dual center analysis of patient characteristics, therapeutic specifics and outcome predictors

“…Electrical injuries are rare but potentially life-threatening emergencies. Voltage exposure is defined by industrial norms as either above or below 1000 V (high voltage injuries (HVI) or low voltage injuries (LVI), respectively) [ 1 ]. The cutoff value of 1000 V is not supported by clinical data, and LVI may cause similar damage to the human body as HVI, depending on individual current pathways, amperage and the duration of current exposure.…”

Blood Flow Dynamics in Burns

“…In most cases, the visual skin burns are quite small and there is usually an entry and an exit burn correlating to the passage of the current. However, there might be extensive damage on other parts of the body, which should always be considered when electrical burns are treated [14].…”

Acute electrical injury: A systematic review

“…Direct electricity has been reported to have higher burn injuries specially in extremities [4,5,7,8]. High-voltage injury has more extremities and muscle injuries, but low-voltage injuries cause more cardiac dysrhythmia, although both can be seen in both injuries [2,11,13,19,21].…”

“…These should be in the mind of attending physicians to prevent and treat the special complications that may happen for the patients. Kidney, heart, nervous system, musculoskeletal system, eyes and ears are among the organs that may be affected during the process of injury [11][12][13][14][15][16].…”