Determining when care for burns is futile.
Age, burn size, inhalation injury, and comorbid diseases are important factors in predicting survival of patients with burn injuries. These same factors are important in attempting to objectively define the point when burn care is futile. We reviewed the records of 3301 patients admitted to our Burn Center between January 1, 1986, and December 31, 1994. There were 114 deaths (3.45%), of which 44 occurred within the first few days of admission. Seventy patients died at a later date. A do-not-resuscitate with comfort-measures-only order was written on 33 patients (26.7%). We have developed objective criteria that include age, extent of burn, presence of inhalation injury, and major organ dysfunction to be applied in the determination of futility of further therapy, either at the time of admission or when patients develop progressive multi-organ system failure during the hospital course.
Fratianne
R B
RB
Case Western Reserve Univeristy MetroHealth Medical Center, Cleveland, Ohio 44109, USA.
Brandt
C P
CP
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008875:Middle Aged; D016414:Resuscitation Orders