Cardiac abnormalities in children with burns: an autopsy analysis.

After observing several cases of endocarditis-related deaths, we determined the contribution of cardiac abnormalities to burn mortality. Autopsy reports of all burn-related deaths between 1964 and 1992 (n = 212) were reviewed for cardiac disease. Cardiac abnormalities were categorized into infectious, acquired, or congenital. Cardiac abnormalities of all forms were associated with longer hospitalizations before death and affected a larger proportion of females than expected in the male-dominated burn population. The highest incidence of endocarditis (17.3% of all deaths) occurred in the past 5 years. The frequency of other forms of cardiac abnormalities has not changed over time. Improved burn management has resulted not only in improved survival but has also prolonged the duration of hospitalization of those patients who ultimately die of their injuries. As patients are kept alive for longer periods, the incidence of endocarditis and the cardiac manifestations of multiple organ failure have increased.