Citation

Krishnan P, Frew Q, Green A, Martin R, Dziewulski P. Burns 2013; 39(4): 583-588.

Affiliation

Burn Service, St. Andrews Centre for Plastic Surgery and Burns, Chelmsford, Essex CM1 7ET, UK; Burn Research Group, St. Andrew's Anglia Ruskin (STAAR) Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Essex, UK. Electronic address: priya199@hotmail.com.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.burns.2012.09.017

PMID

23137628

Abstract

OBJECTIVE: Global mortality from burns is decreasing however there is a relative paucity of mortality data in the literature from burns units in the United Kingdom. We present an analysis of burns deaths and correlation with coroners' autopsy findings from a large regional burns unit. DESIGN: Retrospective medical note review of patients who died over a 7year period (January 2005 to April 2011) was undertaken. Patient demographics were recorded in addition to: burn size, depth, length of stay, presence of inhalational injury, organs failing and diagnosis of sepsis. In order to evaluate the accuracy of our pre-mortem clinical diagnosis, we compared post-mortem cause of death with clinical cause of death. RESULTS: There were 92 deaths out of 4745 admissions for acute burn (crude mortality 1.9%). 37 patients were immediately given comfort care and excluded from analysis. Average age was 52.9years±19.4, average percentage burn 43.7%±26.8, and length of stay 26.4±45days. 80% of deaths were attributable to flame burn (44/55), and 51% (28/55) suffered inhalational injury. Multi-organ failure was the primary cause of death (39/55), with sepsis being the primary trigger (20/39, 51%). Pseudomonas was the most common organism isolated in septic patients. There were significant difficulties in obtaining post-mortem reports and an obvious lack of correlation between coroners' reports and clinical cause of death. CONCLUSIONS: The principal cause of mortality in our unit was multi-organ failure due to sepsis, which concurs with current literature. Autopsy has previously been shown to be a useful retrospective diagnostic tool, however we challenge its reliability as a result of our study.

Language: en