TY - JOUR PY - 2013// TI - Cause of death and correlation with autopsy findings in burns patients JO - Burns: journal of the International Society for Burn Injuries A1 - Krishnan, P. A1 - Frew, Q. A1 - Green, Alexandra A1 - Martin, R. A1 - Dziewulski, P. SP - 583 EP - 588 VL - 39 IS - 4 N2 - 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
LA - en SN - 0305-4179 UR - http://dx.doi.org/10.1016/j.burns.2012.09.017 ID - ref1 ER -