Study determined a regression model of mortality in all pediatric and adult burned patients who were admitted to Shriners Hospitals for Children-Galveston (SHC) or the Blocker Burn Unit (BBU) in Galveston from 1989 to 2017. Age, percent of the total body surface area (TBSA) burned, presence of inhalation injury, length of stay, and survival status were recorded at admission and at discharge for all new burn admissions between 1989 and 2017. The expected mortality probability was calculated using historical multiple regression techniques and compared with observed data. A prediction model was developed for the observed data. There were 10,384 consecutive new burn admission to SHC and BBU between 1989 and 2017, with 355 mortalities (median age = 13 years; median percent TBSA burn = 11 percent). Analyses revealed a significant decrease in observed mortality data compared to historical predictions, and a 2-percent reduction per year in mortality during the 3 decades. The prediction model of mortality for the data indicate that percentage of TBSA burned, patient age, and the presence of inhalation injury are primary determinants of mortality. Findings also suggest that improvements in standardized protocols of burn care have resulted in a lower mortality compared to referenced prediction models from earlier periods. The reduction in mortality over time may be attributed to successful changes in standard of care protocols in the burn center that improved the outlook for burned individuals, including protocols for management of inhalation injury, nutrition, resuscitation, and early excision and grafting.
Author(s):
Capek, Karel D.|Sousse, Linda E.|Hundeshagen, Gabriel|Voight, Charles D.|Suman, Oscar E.|Finnerty, Celeste C.|Jennings, Kristofer|Herndon, David N.|
