Lightning injuries: prognostic signs for death.

A chi-square analysis of 66 cases, including the author's eight cases and 58 from the literature, was undertaken to determine prognostic signs for death in patients seriously injured by lightning. A review of the injuries and of the physics and pathophysiology of lightning is presented. Prognosis was poor for those victims suffering leg burns (mortality 30%), cranial burns (37%), or cardiopulmonary arrest (76%). Death occurred in 30% of the cases studied. Permanent sequelae were found in 74% of the survivors. Nonsignificant factors were age, sex, and trunk and arm burns. Resuscitation of victims exhibiting loss of consciousness should begin immediately, as these are the most likely to die.