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The impact of non-thermal injuries in combined burn trauma: A retrospective analysis over the past 35 years


Getzmann, Jonas M; Slankamenac, Ksenija; Sprengel, Kai; Mannil, Lijo; Giovanoli, Pietro; Plock, Jan A (2019). The impact of non-thermal injuries in combined burn trauma: A retrospective analysis over the past 35 years. Journal of Plastic, Reconstructive & Aesthetic Surgery, 72(3):438-446.

Abstract

Introduction Combined burn trauma is rather uncommon and frequently difficult to manage. Historically combined burn trauma contributed to high mortality rates in severely injured patients. The purpose of this study was to determine the incidence, mechanisms and impact of non-thermal injuries in patients with severe burns. Methods The charts of 2536 patients admitted to the Burn Center of the University Hospital Zurich between 1977 and 2013 were reviewed and retrospectively analyzed. Patients with additional injuries were identified and analyzed statistically. Results Over 35 years from 1977 to 2013 a total of 100 burn patients (3.9%) with additional trauma were identified. Motor vehicle crash was the most common mechanism of injury (44%) from 1977 to 1995, compared to electrical injury (33%) from 1996 to 2013. Skeletal trauma including spinal and pelvic injury was the most common form (71%). Additional thoracic or abdominal trauma represented the highest risk factor for in-hospital mortality (adjusted RR 2.2, 95% CI 0.6–7.6). However, after 1995 the presence of any form of additional injury did not have a significant impact on in-hospital mortality (unadjusted RR 0.97, 95% CI 0.5–1.7, p = 0.914). Conclusions Concomitant trauma did not reveal a significant impact on in-hospital mortality in our burn center recently. Retrospectively, trauma mechanisms shifted from motor vehicle crashes to electrical injuries in our population. Safety measures for motor vehicles and adequate emergency room algorithms seem to have contributed to a reduction of severity of injury and mortality. Keywords Abdominal injury Electric injury Fracture Trauma severity index Mortality

Abstract

Introduction Combined burn trauma is rather uncommon and frequently difficult to manage. Historically combined burn trauma contributed to high mortality rates in severely injured patients. The purpose of this study was to determine the incidence, mechanisms and impact of non-thermal injuries in patients with severe burns. Methods The charts of 2536 patients admitted to the Burn Center of the University Hospital Zurich between 1977 and 2013 were reviewed and retrospectively analyzed. Patients with additional injuries were identified and analyzed statistically. Results Over 35 years from 1977 to 2013 a total of 100 burn patients (3.9%) with additional trauma were identified. Motor vehicle crash was the most common mechanism of injury (44%) from 1977 to 1995, compared to electrical injury (33%) from 1996 to 2013. Skeletal trauma including spinal and pelvic injury was the most common form (71%). Additional thoracic or abdominal trauma represented the highest risk factor for in-hospital mortality (adjusted RR 2.2, 95% CI 0.6–7.6). However, after 1995 the presence of any form of additional injury did not have a significant impact on in-hospital mortality (unadjusted RR 0.97, 95% CI 0.5–1.7, p = 0.914). Conclusions Concomitant trauma did not reveal a significant impact on in-hospital mortality in our burn center recently. Retrospectively, trauma mechanisms shifted from motor vehicle crashes to electrical injuries in our population. Safety measures for motor vehicles and adequate emergency room algorithms seem to have contributed to a reduction of severity of injury and mortality. Keywords Abdominal injury Electric injury Fracture Trauma severity index Mortality

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Department of Trauma Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 March 2019
Deposited On:31 Jan 2019 12:43
Last Modified:14 Feb 2019 02:05
Publisher:Elsevier
ISSN:1748-6815
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.bjps.2018.10.022
PubMed ID:30527710

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