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Multi-institutional analysis of independent predictors for burn mortality in the United States
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. METHODS: We...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103989/ https://www.ncbi.nlm.nih.gov/pubmed/30151396 http://dx.doi.org/10.1186/s41038-018-0127-y |
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author | Zavlin, Dmitry Chegireddy, Vishwanath Boukovalas, Stefanos Nia, Anna M. Branski, Ludwik K. Friedman, Jeffrey D. Echo, Anthony |
author_facet | Zavlin, Dmitry Chegireddy, Vishwanath Boukovalas, Stefanos Nia, Anna M. Branski, Ludwik K. Friedman, Jeffrey D. Echo, Anthony |
author_sort | Zavlin, Dmitry |
collection | PubMed |
description | 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. 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. 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 (p < 0.001), more frequently female (p < 0.001), and had more pre-existing comorbidities (p < 0.001). Total body surface area (TBSA), inhalation injury, hospitalization time, and occurrence of complications were higher compared to survivors (p < 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 (p < 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 (p < 0.001) while overall comorbidities were not a statistical risk factor. 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. |
format | Online Article Text |
id | pubmed-6103989 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-61039892018-08-27 Multi-institutional analysis of independent predictors for burn mortality in the United States Zavlin, Dmitry Chegireddy, Vishwanath Boukovalas, Stefanos Nia, Anna M. Branski, Ludwik K. Friedman, Jeffrey D. Echo, Anthony Burns Trauma Research Article 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. 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. 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 (p < 0.001), more frequently female (p < 0.001), and had more pre-existing comorbidities (p < 0.001). Total body surface area (TBSA), inhalation injury, hospitalization time, and occurrence of complications were higher compared to survivors (p < 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 (p < 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 (p < 0.001) while overall comorbidities were not a statistical risk factor. 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. BioMed Central 2018-08-22 /pmc/articles/PMC6103989/ /pubmed/30151396 http://dx.doi.org/10.1186/s41038-018-0127-y Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Zavlin, Dmitry Chegireddy, Vishwanath Boukovalas, Stefanos Nia, Anna M. Branski, Ludwik K. Friedman, Jeffrey D. Echo, Anthony Multi-institutional analysis of independent predictors for burn mortality in the United States |
title | Multi-institutional analysis of independent predictors for burn mortality in the United States |
title_full | Multi-institutional analysis of independent predictors for burn mortality in the United States |
title_fullStr | Multi-institutional analysis of independent predictors for burn mortality in the United States |
title_full_unstemmed | Multi-institutional analysis of independent predictors for burn mortality in the United States |
title_short | Multi-institutional analysis of independent predictors for burn mortality in the United States |
title_sort | multi-institutional analysis of independent predictors for burn mortality in the united states |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103989/ https://www.ncbi.nlm.nih.gov/pubmed/30151396 http://dx.doi.org/10.1186/s41038-018-0127-y |
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