RESUMEN
BACKGROUND: There are several burn scores used to predict mortality in burn patients. However, minimal data exists on the role of laboratory values in risk stratification. We hypothesized that laboratory derangements seen on admission can predict mortality in burn patients. MATERIALS AND METHODS: A retrospective chart review was conducted on burn patients admitted to a busy Level 1 Trauma and Burn Center from 2013 to 2019. Data analysis included patients with partial or full thickness burns and a total body surface area (TBSA) burn greater than 15%. Exclusion criteria included patients presenting with electrical burns, non-thermal conditions (Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, or soft tissue infections) or patients with significant polytrauma. RESULTS: 112 patients were included in the analysis. Admission phosphate, creatinine, albumin, and glucose levels were associated with mortality. There was a difference in serum phosphate (3.48 and 6.04 mg/dL), creatinine (0.85 and 1.13 mg/dL), albumin (3.26 and 2.3 mg/dL), and glucose (138 and 233 mmol/L) levels for survivors and non-survivors; respectively. There were increased mortality rates seen in patients presenting with abnormal serum levels compared to normal serum levels (Phosphate: 7.5% vs. 53.3%, creatinine: 13.5% vs. 38.9%, albumin: 38.5% vs. 8.10% and glucose: 10.1% vs. 31.6% (normal vs. abnormal; respectively)). Serum sodium, potassium, and hemoglobin levels had no association with mortality. DISCUSSION: Specific laboratory derangements seen on admission are associated with an increased risk for mortality. This can be used as a framework for future studies in risk stratification of burn victims.
RESUMEN
BACKGROUND: A community lockdown has a profound impact on its citizens. Our objective was to identify changes in trauma patient demographics, volume, and pattern of injury following the COVID-19 lockdown. METHODS: A retrospective review was conducted at a Level-1 Trauma Center from 2017 to 2020. RESULTS: A downward trend in volume is seen December-April in 2020 (R2 = 0.9907). February through April showed an upward trend in 2018 and 2019 (R2= 0.80 and R2 = 0.90 respectively), but a downward trend in 2020 (R2 = 0.97). In April 2020, there was 41.6% decrease in total volume, a 47.4% decrease in blunt injury and no decrease in penetrating injury. In contrast to previous months, in April the majority of injuries occurred in home zip codes. CONCLUSIONS: A community lockdown decreased the number of blunt trauma, however despite social distancing, did not decrease penetrating injury. Injuries were more likely to occur in home zip codes.