TY - JOUR PY - 2021// TI - Massive burns: retrospective analysis of changes in outcomes indicators across 18 years JO - Journal of burn care and research A1 - Meuli, Joachim N. A1 - Pantet, Olivier A1 - Berger, Mette M. A1 - Waselle, Laurent A1 - Raffoul, Wassim SP - ePub EP - ePub VL - ePub IS - ePub N2 - 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

LA - en SN - 1559-047X UR - http://dx.doi.org/10.1093/jbcr/irab072 ID - ref1 ER -