Citation

Meuli JN, Pantet O, Berger MM, Waselle L, Raffoul W. J. Burn Care Res. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1093/jbcr/irab072

PMID

unavailable

Abstract

BACKGROUND: The treatment and management of massive burns, defined as burns affecting≥ 50% of total body surface area (TBSA) has considerably changed since the 90s. This study aimed at analyzing if the length of intensive care unit (ICU) stay, the success of skin grafting operations and the mortality changed in the last 18 years.

METHODS: Between 2000 and 2018, 77 patients were admitted for massive burns to the ICU of a university hospital. Transfers and early care withdrawal precluded inclusion for 38 patients, leaving 39 for analysis. Study variables were year of admission, demographics, burn characteristics, critical care treatment (fluid resuscitation, ventilation and nutrition) and surgical therapy. Association between outcomes and year of admission were assessed through correlation and logistic regression analysis. Potential confounders were assessed through stepwise linear regression.

RESULTS: Patients' characteristics were stable over time with a median age of 36[25.0, 48.0] years, burns 65% [55.0, 83.0] TBSA and deep burns 55% [50.0, 68.0] TBSA. Length of ICU stay remained stable at 0.97 [0.6, 1.5] days/%TBSA. Mortality was stable as well. Energy and carbohydrate delivery decreased in parallel with the number of infectious episodes per patient. Number of operations was stable but the take rate of skin grafts increased significantly. The multivariate analysis retained year of admission, weight, total number of infections, daily lipid intakes and fluid resuscitation as independent predicting variables.

CONCLUSION: Length of ICU stay and mortality did not change over time but skin grafts take rates improved significantly.

Language: en

Keywords

burn infections; burn intensive care unit; burn nutrition; burn surgery; critical illness; cultured epithelial autografts; massive burns; skin grafts