title: Factors impacting the likelihood of death in patients with small TBSA burns.
abstract: Survival rates of burn patients have increased greatly over the past several decades. There are, however, still patients with relatively small burns who do not survive their hospitalizations. This work aimed to elucidate factors common to this select subset of patients. The NBR Main dataset was queried for record numbers associated with TBSA between 0.1 and 10 and a discharge status indicating death. Using SAS statistical software, the patients were matched for age, sex, and TBSA. Chi-square analyses of independence on categorical variables and unpaired, two-tailed Students' t-tests with unequal variance on continuous variables were used to identify fields of further interest. SAS was then used to build multivariate logistic regression models examining variables affecting discharge status. The NBR complications child dataset was queried and categorized for the types of complications for analysis. Multivariate logistic regression for discharge status, comorbidities, and complications showed that the presence of a complication significantly impacted discharge status. The presence of an identified complication (other than death) increased the odds ratio of a discharge status of death by a factor of 3.023 (95% confidence interval [2.306, 3.964], P < .0001). Pulmonary and infection-related complications were the most frequently seen across all the records analyzed, but infection-related complications did not reach statistical significance in relation to discharge status. Multivariate logistic regression of complications in a model for discharge status identified four categories as statistically significant: neurologic, cardiovascular, pulmonary, and renal. In patients with small TBSA burns, the presence of complications significantly increases the odds ratio of death as judged by the NBR data. The complications which appear to be of particular interest are cardiovascular, neurologic, renal, and pulmonary, and those patients who are likely most susceptible to these complications are those with inhalation injury in addition to their cutaneous burns.
authors.affiliation: From The Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC.
authors.forename: Taryn E
authors.initials: TE
authors.lastname: Travis
authors.forename: Lauren T
authors.initials: LT
authors.lastname: Moffatt
authors.forename: Marion H
authors.initials: MH
authors.lastname: Jordan
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Shupp
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002053:Burn Units; D002056:Burns / Q000150:complications / Q000401:mortality* / Q000473:pathology*; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014481:United States