Trends in the epidemiology of major burn injury among hospitalized patients: A population-based analysis

Abstract

Background Burn-related mortality has decreased significantly over the past several decades. While often attributed in part to regionalization of burn care, this has not been evaluated at the population level. Methods We conducted a retrospective, population-based cohort study of all patients with > 20% total burned surface area (TBSA) burn injury in Ontario, Canada. Adult (>16y) patients injured between 2003–2013 were included. Deaths in the emergency department were excluded. Logistic generalized estimating equations were used to estimate risk-adjusted 30-day mortality. Mortality trends were compared at burn and non-burn centers. Results 772 patients were identified at 84 centers (2 burn, 82 non-burn). Patients were 74% (n=570) male, of median age 46 (IQR 35–60) years and median TBSA 35% (IQR 25–45). Mortality at 30 days was 19% (n=149). The proportion of patients treated at a burn center increased from 57% to 71% between 2003–2013 (p=0.07). Average risk-adjusted 30-day mortality rates decreased over time; there were significantly reduced odds of death in 2010–2013 compared to 2003–2006 (OR 0.39, 95% CI 0.25–0.61). Burn centers exhibited significantly reduced mortality from 2003–2006 to 2010–2013 (OR 0.36, 95% CI 0.34–0.38) compared to non-designated centers (OR 0.41, 95% CI 0.13–1.24). Conclusions Mortality rates have decreased over time; significant improvements have occurred at burn centers while mortality rates at non-designated centers vary widely. A high proportion of patients continue to receive care outside of burn centers. These data suggest there are further opportunities to regionalize burn care and in so doing, potentially lower burn-related mortality. Level of Evidence Level III epidemiological study

Patterns and Sequelae of burn injury at the Jordanian Royal Medical Services rehabilitation center in 2005-2017: a cross-sectional study

“…Acknowledging the mortality rates was necessary for the research. Overall mortality in this study fell close to other published works (20,21,35), and less than others which might reach as much as 37.6% (32). Mortality was mostly of domestic occurrence.…”

Effects of COVID-19 pandemic on burns epidemiology

“…Trends in the epidemiology of burn injuries had been frequently studied [1,2]. In this study, the effect of pandemic disease on incidence of burns is explored.…”

Evolución histórica de la mortalidad de los pacientes internados en el Centro Nacional de Quemados entre 1995 y 2017

“…La mortalidad de los pacientes ha descendido fundamentalmente en los centros de quemados (12) . El estudio de Mason y colaboradores, que analizó 772 pacientes quemados, puso en evidencia que la mortalidad de los pacientes asistidos en centros especializados descendió a lo largo del tiempo, en comparación con lo ocurrido en los centros no especializados (13) . Por otra parte, el momento del ingreso a los centros especializados también impacta en resultados.…”

“…La mortalidad de los pacientes quemados ha presentado un descenso constante. Más allá del mayor conocimiento de las alteraciones fisiopatológicas que ocurren en el paciente quemado y de los avances terapéuticos, la experiencia en el manejo de esta patología, así como la mejor interacción de diferentes especialidades, se asocian a este incremento de la sobrevida (3,4) .…”