Epidemiology and outcome analysis of burn patients admitted to an Intensive Care Unit in a University Hospital
Introduction
Loss of skin integrity by injury or disease can result in important physiological imbalance, serious dysfunction or death. The most common causes of skin loss are burns, trauma and chronic wounds. A severely burned patient poses a challenge for a multidisciplinary therapeutic approach and has a great social impact because it affects a wide age range, including young adult patients of working age, and often leaves permanent sequelae [1]. The severity of a burn is mainly related to the total body surface area (TBSA), lesion depth and extreme ages. Inhalation injury is also described as one of the main factors that are associated with increased mortality [2].
According to the World Health Organization (WHO), approximately 11 million victims of burn per year need specialized care worldwide, becoming the fourth leading cause of direct trauma. It is estimated that a direct flame is responsible for 300,000 deaths each year. Although mortality from burns has been reduced in recent decades, 90% of the deaths occur in low and middle income countries. Risk factors for the occurrence of burns include socioeconomic status, race, ethnicity, age, gender, environment, comorbidities, regional factors and intent of injury, e.g., in homicide or suicide cases [3].
In Brazil, according to the Brazilian Society of Burns, about one million incidents involving burns occur each year, resulting in approximately 100,000 hospitalizations. The mortality rate from burns by flames in Brazil is 0.8/100,000 population/year, resulting in 1600 deaths per year [4]. Specialized units for burn treatment are scarce and unevenly distributed in Brazil. Of the 46 existing units in the country, 25 are concentrated in the southeast region [5].
Epidemiological studies with Latin American and especially Brazilian data are scarce, justifying an epidemiologic study with regional data. The present study was designed to answer questions about the most frequent causes of burns, clinical characteristics of patients and risk factors for death.
Section snippets
Methods
A longitudinal and retrospective study involving patients admitted to the Intensive Care Unit of the Burn Center of a University Hospital was conducted from January 2010 to December 2012. The Burn Center is composed of sixteen beds distributed in six Intensive Care Unit (ICU) beds and 10 ward beds, one emergency room and one operating room. All patients who were consecutively admitted in the six-bed ICU were included in the study period. Exclusion criteria were length of ICU stay less than 24 h,
Results
From January 2010 to December 2012, 414 patients were admitted in the six-bed ICU of the Burn Center. Reasons for patient exclusions were 80 patients who were less than 18 years old, one patient who was admitted for burn sequelae, four patients who had Stevens–Johnson syndrome, 18 patients who stayed less than 24 h in the ICU and 18 patients with other diagnoses. Therefore, 293 patients were analyzed in the study (Fig. 1). Patients had a median age of 38 years (interquartile range [ITQ] 28–52);
Discussion
This study evaluated the epidemiological data of burn patients who were admitted to an Intensive Care Unit that specialized in burns at a University Hospital. Because this is a study that examines severe burns, our patients had greater TBSA and a higher mortality than those described in other studies [14], [15], [16], [17]. In Lacerda et al., 65.35% of patients were considered to have a low severity of burns, with an average of 11.3% TBSA, resulting in an overall mortality rate of 5.94% [17]. A
Contributors
Queiroz, LFT: conception of the study, acquisition of data, drafting the article, final approval of the version to be submitted.
Grion, CMC: design of the study, analysis and interpretation of data, revising the article, final approval of the version to be submitted.
Anami, EHT: conception of the study, acquisition of data, revising the article, final approval of the version to be submitted.
Zampar, EF: conception of the study, acquisition of data, revising the article, final approval of the
Conflict of interest
None declared.
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