title: Cause of death and correlation with autopsy findings in burns patients.
abstract: OBJECTIVE
  Global mortality from burns is decreasing however there is a relative paucity of mortality data in the literature from burns units in the United Kingdom. We present an analysis of burns deaths and correlation with coroners' autopsy findings from a large regional burns unit.
  
  
  METHODS
  Retrospective medical note review of patients who died over a 7 year period (January 2005 to April 2011) was undertaken. Patient demographics were recorded in addition to: burn size, depth, length of stay, presence of inhalational injury, organs failing and diagnosis of sepsis. In order to evaluate the accuracy of our pre-mortem clinical diagnosis, we compared post-mortem cause of death with clinical cause of death.
  
  
  RESULTS
  There were 92 deaths out of 4745 admissions for acute burn (crude mortality 1.9%). 37 patients were immediately given comfort care and excluded from analysis. Average age was 52.9 years±19.4, average percentage burn 43.7%±26.8, and length of stay 26.4±45 days. 80% of deaths were attributable to flame burn (44/55), and 51% (28/55) suffered inhalational injury. Multi-organ failure was the primary cause of death (39/55), with sepsis being the primary trigger (20/39, 51%). Pseudomonas was the most common organism isolated in septic patients. There were significant difficulties in obtaining post-mortem reports and an obvious lack of correlation between coroners' reports and clinical cause of death.
  
  
  CONCLUSIONS
  The principal cause of mortality in our unit was multi-organ failure due to sepsis, which concurs with current literature. Autopsy has previously been shown to be a useful retrospective diagnostic tool, however we challenge its reliability as a result of our study.
authors.affiliation: Burn Service, St. Andrews Centre for Plastic Surgery and Burns, Chelmsford, Essex CM1 7ET, UK. priya199@hotmail.com
authors.forename: P
authors.initials: P
authors.lastname: Krishnan
authors.forename: Q
authors.initials: Q
authors.lastname: Frew
authors.forename: A
authors.initials: A
authors.lastname: Green
authors.forename: R
authors.initials: R
authors.lastname: Martin
authors.forename: P
authors.initials: P
authors.lastname: Dziewulski
mesh_terms: D000328:Adult; D000368:Aged; D001344:Autopsy; D002056:Burns / Q000150:complications / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000401:mortality; D012189:Retrospective Studies; D018805:Sepsis / Q000382:microbiology / Q000401:mortality; D012737:Sex Factors; D006113:United Kingdom / Q000453:epidemiology