A 10-year experience with major burns from a non-burn intensive care unit

• Published in: Burns Vol. 40; no. 6; pp. 1225 - 1231
• Main Authors: Ibarra Estrada, Miguel Ángel, Chávez Peña, Quetzalcóatl, García Guardado, Dante Ismael, López Pulgarín, José Arnulfo, Aguirre Avalos, Guadalupe, Corona Jiménez, Federico
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.09.2014
• Subjects: Adult; Age Distribution; Burns - mortality; Critical Care; Critical Illness; Female; Hospital Mortality; Humans; Intensive Care Units - statistics & numerical data; Length of Stay - statistics & numerical data; Major burn; Male; Mexico - epidemiology; Middle Aged; Mortality; Multivariate Analysis; Non-burn ICU; Odds Ratio; Prognosis; Retrospective Studies; Risk Factors; Sex Distribution; Survival Analysis; Trauma Severity Indices; Mexico; Non-burn ICU; Major burn; Prognosis; Mortality
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2013.12.020

Abstract Objective The aim of this study was to review clinical data and outcomes of patients with burns in a Mexican non-burn intensive care unit (ICU). Methods We did a retrospective analysis of our single-centre database of burn patients admitted to the ICU in the Hospital Civil Fray Antonio Alcalde (University Hospital). The sample was divided for analysis into two groups according to the outcome ‘death’ or ‘discharge’ from ICU. Results Overall mortality was 58.2%, without a decreasing trend in mortality rates through the years. We identified the presence of third-degree burns (odds ratio (OR) 1.5, p = 0.003), and >49% total burned surface area (TBSA; OR 3.3, p ≤ 0.001) was associated with mortality. Mean age was higher in deceased patients (38.2 years vs. 31.3 years, p = 0.003) as was the TBSA (62.8% vs. 36.4%, p ≤ 0.001). At multivariate analysis, inhalation injury was not associated with increased mortality, but it was with more mechanical ventilation days. Early surgical debridement/cleansing was performed in most patients; however, the mean of the procedures was 1.7 per patient in both groups. Conclusion We identified significant factors associated with mortality. These variables and prognosis from non-burn ICUs differ broadly compared with burn intensive care units (BICUs); thus, more structured, multidisciplinary and specialised treatment strategies are still needed.