Social support correlates with survival in patients with massive burn injury.
Large burn size, inhalation injury, age, and associated trauma increase the rate of mortality after burns. However, not all patients with large burns and significant risk factors die. In this study, we wanted to determine other presenting factors that might indicate a survival benefit for burn patients with large burns. We reviewed charts of 36 patients with burns > or =60% TBSA that were aggressively resuscitated at the University of Washington Burn Center from 1990 to 2000 to determine whether survivors of large burns exhibit presenting variables that predict survival. Patients who had comfort care measures initiated at admission were excluded from this analysis. Survivors (n = 16) and nonsurvivors (n = 20) had no significant differences in age, total burn size, inhalation injury, or need for escharotomy. Full-thickness burn size was significantly smaller for survivors (58%) than for nonsurvivors (73%; P = .02). Survivors (81%) were more likely than nonsurvivors to have social support (35%; P = .007). A full-thickness burn > or =80 % TBSA was the only variable uniformly associated with mortality, suggesting that patients who survive large burns have a partial-thickness component that heals without surgery. The difference in degree of social support was one unique distinction that may impact patient survival and is worth further investigation.
Muangman
Pornprom
P
University of Washington Burn Center, and Harborview Medical Center, 325 Ninth Avenue, Seattle, WA 98104, USA.
Sullivan
Stephen R
SR
Wiechman
Shelley
S
Bauer
Gregory
G
Honari
Shari
S
Heimbach
David M
DM
Engrav
Loren H
LH
Gibran
Nicole S
NS
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002056:Burns / Q000145:classification / Q000401:mortality* / Q000523:psychology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002809:Chondroitin Sulfates / Q000627:therapeutic use; D003094:Collagen / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017768:Skin, Artificial / Q000706:statistics & numerical data; D012944:Social Support; D016019:Survival Analysis; D014861:Washington / Q000453:epidemiology
C114835:integra artificial skin; D002809:Chondroitin Sulfates; D003094:Collagen