Emergency Care for Burn Patients-A Single-Center Report

Andrei Niculae; Ileana Peride; Mirela Tiglis; Ana Maria Nechita; Lucian Cristian Petcu; Tiberiu Paul Neagu

doi:10.3390/jpm13020238

Emergency Care for Burn Patients-A Single-Center Report

J Pers Med. 2023 Jan 28;13(2):238. doi: 10.3390/jpm13020238.

Authors

Andrei Niculae¹, Ileana Peride¹, Mirela Tiglis², Ana Maria Nechita³, Lucian Cristian Petcu⁴, Tiberiu Paul Neagu⁵

Affiliations

¹ Clinical Department No. 3, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
² Department of Anesthesia and Intensive Care, Emergency Clinical Hospital of Bucharest, 014461 Bucharest, Romania.
³ Department of Nephrology and Dialysis, "St. John" Emergency Hospital, 042122 Bucharest, Romania.
⁴ Department of Biophysics and Biostatistics, Faculty of Dentistry, "Ovidius" University, 900684 Constanta, Romania.
⁵ Clinical Department No. 11, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Abstract

Burns, one of the main public health problems, lead to significant mortality and morbidity. Epidemiological studies regarding burn patients in Romania are scarce. The aim of this study is to identify the burn etiology, demographics, clinical characteristics, and outcomes in patients requiring treatment in a regional burn unit.

Design: We performed a retrospective observational study of 2021.

Patients: All patients admitted to our six-bed intensive care unit (ICU) were included.

Interventions: The following data were collected for further analysis: demographics, burn pattern (etiology, size, depth, affected body region), type of ventilation, ABSI (Abbreviated Burn Severity Index) score, comorbidities, bioumoral parameters, and hospitalization days.

Results: There were 93 burned patients included in our study that were divided into two groups: alive patients' group (63.4%) and deceased patients' group (36.6%). The mean age was 55.80 ± 17.16 (SD). There were 65.6% male patients, and 39.8% of the patients were admitted by transfer from another hospital. Further, 59 patients presented third-degree burns, from which 32.3% died. Burns affecting >37% of the total body surface area (TBSA) were noticed in 30 patients. The most vulnerable regions of the body were the trunk (p = 0.003), the legs (p = 0.004), the neck (p = 0.011), and the arms (p = 0.020). Inhalation injury was found in 60.2% of the patients. The risk of death in a patient with an ABSI score > 9 points was 72 times higher. Comorbidities were present in 44.1% of the patients. We observed a median LOS (length of stay) of 23 days and an ICU-LOS of 11 days. Logistic regression analysis showed that admission protein, creatinkinase, and leukocytes were independent risk factors for mortality. The general mortality rate was 36.6%.

Conclusion: A thermal factor was responsible for the vast majority of burns, 94.6% of cases being accidents. Extensive and full-thickness burns, burns affecting the arms, inhalation injuries, the need for mechanical ventilation, and a high ABSI score represent important risk factors for mortality. Considering the results, it appears that prompt correction of protein, creatinkinase, and leukocytes levels may contribute to improvement in severe burn patients' outcomes.

Keywords: burn etiology; burn injury; epidemiology; outcome; regional burn unit.

Grants and funding

Publication of this paper was supported by the University of Medicine and Pharmacy Carol Davila, through the institutional program Publish not Perish.