title: Determinants of death following burn injury.
abstract: BACKGROUND
  Burn care has changed considerably. Early surgery, nutritional support, improved resuscitation and novel skin replacement techniques are now well established. The aim of the study was to establish whether changes in management have improved survival following burn injury and to determine the contributory factors leading to non-survival.
  
  
  METHODS
  This was a retrospective outcome analysis of data collected from a consecutive series of 4094 patients with burns admitted to a tertiary referral, metropolitan teaching hospital between 1972 and 1996.
  
  
  RESULTS
  The overall mortality rate was 3.6 per cent. This decreased from 5.3 per cent (1972--1980) to 3.4 per cent (1993--1996) (P = 0.076). The risk of death was increased with increasing burn size (relative risk (RR) 95.90 (95 per cent confidence interval 12.60--729.47) if more than 35 per cent of the total body surface area was burned; P < 0.001) increasing age (RR 7.32 (3.08--17.42) if aged more than 48 years; P < 0.001), inhalation injury (RR 3.61 (2.39--5.47); P < 0.001) and female sex (RR 1.82 (1.23--2.69); P = 0.003). Operative intervention (RR 0.11 (0.06--0.21); P < 0.001) and the presence of an upper limb burn (RR 0.53 (0.35--0.79); P = 0.002) decreased the risk.
  
  
  CONCLUSIONS
  Modern burn care has decreased the mortality rate. Increasing burn size, increasing age, inhalation injury and female sex increased, while operative intervention and an upper limb burn decreased, the risk of death. Presented to the 10th Congress of the International Society for Burn Injuries, in Jerusalem, November 1998
authors: Department of Surgery, Royal Brisbane Hospital, Queensland, Australia. mmuller@middlemore.co.nz
authors: M J
authors: MJ
authors: Muller
authors: S P
authors: SP
authors: Pegg
authors: M R
authors: MR
authors: Rule
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002056:Burns / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002059:Burns, Inhalation / Q000401:mortality; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis