The Burns Evaluation and Mortality Study (BEAMS)

Moore, Edwina C.; Pilcher, David; Bailey, Michael; Stephens, Hugh; Cleland, Heather

doi:10.1097/ta.0b013e318295409d

Cited by 47 publications

(19 citation statements)

References 26 publications

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“…Wu et al showed increased plasma transfusion in burned females [26], and a paediatric study reported increased blood loss during surgery in males [11]. "Overtransfusion" of women has previously been identified in association with elective surgical procedures [28], and we have reported increased mortality in female critically ill burns patients [29]. There are gender differences in aspects of burn care, including transfusion requirements, however, at present these differences are insufficiently well understood and require further research.…”

Section: Discussionmentioning

confidence: 70%

Treatment of Anaemia in Patients with Acute Burn Injury: A Study of Blood Transfusion Practices

Ţichil

Rosenblum

Paul

et al. 2021

JCM

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Objective: To determine blood transfusion practices, risk factors, and outcomes associated with the use of blood products in the setting of the acute management of burn patients at the Victorian Adult Burn Service. Background: Patients with burn injuries have variable transfusion requirements, based on a multitude of factors. We reviewed all acute admissions to the Victorian Adult Burns Service (VABS) between 2011 and 2017: 1636 patients in total, of whom 948 had surgery and were the focus of our analysis. Method and results: Patient demographics, surgical management, transfusion details, and outcome parameters were collected and analyzed. A total of 175 patients out of the 948 who had surgery also had a blood transfusion, while 52% of transfusions occurred in the perioperative period. The median trigger haemoglobin in perioperative was 80mg/dL (IQR = 76–84.9 mg/dL), and in the non-perioperative setting was 77 mg/dL (IQR = 71.61–80.84 mg/dL). Age, gender, % total body surface area (TBSA) burn, number of surgeries, and intensive care unit and hospital length of stay were associated with transfusion. Conclusions: The use of blood transfusions is an essential component of the surgical management of major burns. As observed in our study, half of these transfusions are related to surgical procedures and may be influenced by the employment of blood conserving strategies. Furthermore, transfusion trigger levels in stable patients may be amenable to review and reduction. Risk adjusted analysis can support the implementation of blood transfusion as a useful quality indicator in burn care.

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Section: Discussionmentioning

confidence: 70%

Treatment of Anaemia in Patients with Acute Burn Injury: A Study of Blood Transfusion Practices

Ţichil

Rosenblum

Paul

et al. 2021

JCM

Self Cite

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“…An explanation might be that females’ willingness to report problems is greater [ 47 ] or that women find it harder to live with a mutilated body. Females also reported higher levels of fatigue and higher mortality rates after burn injuries [ 47 , 48 ]. Besides, poorer outcomes in females have been shown in injury studies in general [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of health-related quality of life after burn injuries: a systematic review

et al. 2018

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BackgroundIdentifying predictors of health-related quality of life (HRQL) following burns is essential for optimization of rehabilitation for burn survivors. This study aimed to systematically review predictors of HRQL in burn patients.MethodsMedline, Embase, Web of Science, Cochrane, CINAHL, and Google Scholar were reviewed from inception to October 2016 for studies that investigated at least one predictor of HRQL after burns. The Quality in Prognostic Studies tool was used to assess risk of bias of included studies.ResultsThirty-two studies were included. Severity of burns, postburn depression, post-traumatic stress symptoms, avoidance coping, less emotional or social support, higher levels of neuroticism, and unemployment postburn were found to predict a poorer HRQL after burns in multivariable analyses. In addition, weaker predictors included female gender, pain, and a postburn substance use disorder. Risk of bias was generally low in outcome measurement and high in study attrition and study confounding.ConclusionsHRQL after burns is affected by the severity of burns and the psychological response to the trauma. Both constructs provide unique information and knowledge that are necessary for optimized rehabilitation. Therefore, both physical and psychological problems require attention months to years after the burn trauma.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2071-4) contains supplementary material, which is available to authorized users.

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“…Renal function is taken into account as one of the factors affecting mortality of burned patients only in the scales generally used in Intensive Care Units based on the APACHE II system. FLAME and BEAMS scales are examples of the scales used in patients with burns [ 23 , 24 ]. None of the scales directly takes into account the strong relationship between the occurrence of renal failure and increased risk of death, which is shown in our analysis.…”

Section: Discussionmentioning

confidence: 99%

Early and Late Acute Kidney Injury in Severely Burned Patients

et al. 2016

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BackgroundThis study evaluated factors influencing early and late occurrence of AKI in severely burned patients and assessed the relationship between time of occurrence of AKI and mortality of AKI patients.Material/MethodsRenal function was evaluated at 3 time points: at admission, at the critical point or middle point of hospitalization, and at the endpoint for which death or a discharge from the center was considered. AKI criteria were: decrease in GFR of less than 60 ml/min at admission, decrease in GFR of more than 75% compared to baseline, and decrease in the daily diuresis of less than 500 ml/24 h.ResultsAt admission, 15.1% of the patients had eGFR <60 ml/min. AKI occurred in 38.5% of cases. The occurrence of AKI was associated with: elderly age (p<0.001), female sex (p=0.017), overweight and obesity (p=0.055); extent and depth of burns, respiratory failure, low protein concentration (for all p<0.001), low blood pressure (p=0.014), and high WBC (p=0.010). Early AKI was detected in 28% of patients. Mortality was 100% with the initial GFR ≥60, 100% with the initial GFR <60 and early deterioration of renal function, 80% with the initial GFR <60 and late worsening, and 60% with the initial GFR <60 and no worsening. Late AKI was observed in 10% of patients and mortality in this group was 79.2%. Mortality in the entire group with AKI was 88.0% versus 24.5%.ConclusionsThe frequent occurrence of AKI, especially early, worsens the prognosis for survival. Assessment of renal function should be included in the prognostic scales for burned patients.

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The Burns Evaluation and Mortality Study (BEAMS)

Abstract: A highly discriminatory mortality prediction model was developed using logistic regression. Risk of death following major burns can be predicted from a combination of physiologic and burns specific parameters. Female sex is a highly significant risk factor.

Cited by 47 publications

References 26 publications

Treatment of Anaemia in Patients with Acute Burn Injury: A Study of Blood Transfusion Practices

Treatment of Anaemia in Patients with Acute Burn Injury: A Study of Blood Transfusion Practices

Predictors of health-related quality of life after burn injuries: a systematic review

Early and Late Acute Kidney Injury in Severely Burned Patients

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