TY  - JOUR
PY  - 2018//
TI  - Multi-institutional analysis of independent predictors for burn mortality in the United States
JO  - Burns and trauma
A1  - Zavlin, Dmitry
A1  - Chegireddy, Vishwanath
A1  - Boukovalas, Stefanos
A1  - Nia, Anna M.
A1  - Branski, Ludwik Krzysztof
A1  - Friedman, Jeffrey D.
A1  - Echo, Anthony
SP  - 24
EP  - 24
VL  - 6
IS  - 
N2  - BACKGROUND: Previous reports individually identified different factors that predict death after burns. The authors employed the multi-center American Burn Association's (ABA) National Burn Repository (NBR) to elucidate which parameters have the highest negative impact on burn mortality. <br><br>METHODS: We audited data from the NBR v8.0 for the years 2002-2011 and included 137,061 patients in our study. The cases were stratified into two cohorts based on the primary outcome of death/survival and then evaluated for demographic data, intraoperative details, and their morbidity after admission. A multivariable regression analysis aimed to identify independent risk factors associated with mortality. <br><br>RESULTS: A total of 3.3% of patients in this analysis did not survive their burn injuries. Of those, 52.0% expired within 7 days after admission. Patients in the mortality cohort were of older age (<i>p</i> < 0.001), more frequently female (<i>p</i> < 0.001), and had more pre-existing comorbidities (<i>p</i> < 0.001). Total body surface area (TBSA), inhalation injury, hospitalization time, and occurrence of complications were higher compared to survivors (<i>p</i> < 0.001). Lack of insurance (odds ratio (OR) = 1.84, confidence interval (CI) 1.38-2.46), diabetes (OR = 1.24, CI 1.01-1.53), any complication (OR = 4.09, CI 3.27-5.12), inhalation injury (OR = 3.84, CI 3.38-4.36), and the need for operative procedures (OR = 2.60, CI 2.20-3.08) were the strongest independent contributors to mortality after burns (<i>p</i> < 0.001). Age (OR = 1.07, CI 1.06-1.07) and TBSA (OR = 1.09, CI 1.09-1.09) were significant on a continuous scale (<i>p</i> < 0.001) while overall comorbidities were not a statistical risk factor. <br><br>CONCLUSION: Uninsured status, inhalation injury, in-hospital complications, and operative procedures were the strongest mortality predictors after burns. Since most fatal outcomes (52.0%) occur within 7 days after injury, physicians and medical staff need to be aware of these risk factors upon patient admission to a burn center.<p />  <p>Language: en</p>
LA  - en
SN  - 2321-3868
UR  - http://dx.doi.org/10.1186/s41038-018-0127-y
ID  - ref1
ER  -