Epidemiology and outcome analysis of burn patients admitted to an Intensive Care Unit in a University Hospital.

OBJECTIVES

To describe the epidemiologic aspects of burn victims who were hospitalized in the Intensive Care Unit (ICU) at the Burn Center in the University Hospital of the State University of Londrina (UEL).

METHODS

A longitudinal retrospective study was conducted, involving patients admitted to the Intensive Care Unit of the Burn Center from January 2010 to December 2012. Demographic and diagnostic data including the diagnosis of the extent and causes of the burns, complications resulting from the burns and the need for specific surgical interventions were collected, together with data for the calculation of the Acute Physiology and Chronic Health Evaluation (APACHE II), Sequential Organ Failure Assessment (SOFA), Therapeutic Intervention Scoring System (TISS-28) and Abbreviated Burn Severity Index (ABSI). Data were collected at admission and daily until discharge from the burn Intensive Care Unit. Risk factors for death and the prognostic performance of scores to predict mortality were analyzed. The level of significance was set at 5%.

RESULTS

Two hundred ninety-three patients were analyzed in the study; 68.30% were men, with a median age of 38 years (interquartile range: 28-52). The mean total body surface area burned was 26.60±18.05%. Home incidents were the most frequent cause, occurring in 53.90% of the cases. Fire was the most common cause, found in 77.10% of patients. Liquid alcohol was the most common agent and was associated with 51.50% of the cases. The ABSI presented a median of 7, and the area under the ROC curve was 0.890. In multivariate analysis, age (p<0.001), female gender (p=0.02), total body surface area burned (p<0.001), mechanical ventilation (p<0.001) and acute renal failure (p<0.001) were all associated with mortality. ICU mortality was 32.80%, and hospital mortality was 34.10%.

CONCLUSION

Burns most often occurred in young adult men in our study. The most common cause was a direct flame. Liquid alcohol was the most frequent accelerating agent. Patients were considered to be severely burned. Most of the samples had a high mean total body surface area burned. The ABSI score showed the best performance in discriminating non-survivors. Hospital mortality rate was high.