Burn Service, St. Andrews Centre for Plastic Surgery and Burns, Chelmsford, Essex CM1 7ET, UK.
Burns. 2013 Jun;39(4):583-8. doi: 10.1016/j.burns.2012.09.017. Epub 2012 Nov 6.
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.
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.
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.
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.
全球烧伤死亡率正在下降，但英国烧伤病房的死亡率数据相对较少。我们对一个大型区域性烧伤病房的烧伤死亡病例进行了分析，并与验尸官的尸检结果进行了相关性分析。
对 7 年间（2005 年 1 月至 2011 年 4 月）死亡的患者进行了回顾性病历回顾。记录了患者的人口统计学数据，以及烧伤面积、深度、住院时间、吸入性损伤、器官衰竭和败血症的诊断。为了评估我们生前临床诊断的准确性，我们将死后的死因与生前的死因进行了比较。
4745 例急性烧伤患者中有 92 例死亡（粗死亡率为 1.9%）。37 例患者立即给予舒适护理，未纳入分析。平均年龄为 52.9 岁±19.4，平均烧伤面积为 43.7%±26.8，住院时间为 26.4±45 天。80%的死亡归因于火焰烧伤（44/55），51%（28/55）有吸入性损伤。多器官衰竭是主要死因（39/55），败血症是主要诱因（20/39，51%）。脓毒症患者分离的最常见病原体是铜绿假单胞菌。获得尸检报告存在很大困难，验尸官报告与生前死因明显缺乏相关性。
本单位死亡的主要原因是败血症引起的多器官衰竭，这与目前的文献一致。尸检以前被证明是一种有用的回顾性诊断工具，但由于我们的研究，我们对其可靠性提出了质疑。
