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We report a rare case of vocal cord injury from an electrical burn, managed successfully with conservative, non-invasive treatment. This unique case illustrates potential complications of electrical trauma and underscores the need for vigilance and consideration of conservative management approaches.
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High-voltage electrical injuries, especially from lightning strikes, can cause life-threatening complications due to extreme temperature and voltage exposure. While burns and cardiac complications have been widely described, the documentation of metabolic imbalances, particularly hypokalemia, has not been as prevalent. This report focuses on a patient with profound transient hypokalemia following a lightning strike, alongside a review of three similar cases of transient hypokalemia from the literature. Our patient, a previously healthy young man, was struck by lightning and subsequently suffered transient hypokalemia with lower extremity sensory changes, which resolved after the normalization of serum potassium levels. While the exact underlying mechanisms of transient hypokalemia following high-voltage electrical injuries are unknown, we propose a multifactorial mechanism, which includes massive intracellular shifts of potassium due to elevated epinephrine levels and the prevention of potassium efflux through the electrical disruption of voltage-gated potassium channels. Our report underscores the importance of recognizing hypokalemia in patients with high-voltage electrical injuries and contributes to the understanding of the complex mechanisms involved. Further research is necessary to understand the connection between cellular changes induced by high-voltage exposure and their effects on metabolism, particularly in relation to hypokalemia.
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Burns affect 11 million people worldwide annually. Electrical burns are renowned for inflicting extensive harm and long-term consequences that can lead to severe illnesses and fatalities. People in both occupational and non-occupational settings may be exposed to electrical burns, leading to functional or anatomical consequences. We identified sociodemographic features related to electrical burns in both settings. A cross sectional design, using an open dataset of electrical shock injuries occurred in Colombia during 2010-2021 period, was carried out. Sociodemographic features of people injured in occupational and non-occupational settings were described in counts (%), incidence per 100.000 people (I0;95% CI). To identify related factors (age-sex adjusted) with injuries in occupational and non-occupational settings, we applied a Binary Logistic Regression. Over the 12-year period, there were 1.274 electrical burns (I0: 2.47;2.34-2.61), 287 in the occupational setting (I0: 1.35;1.20-1.51) and 987 in the non-occupational setting (I0: 3.25;3.05-3.46). Age median was 31 years, most cases distributed in middle adulthood (52.8%), males (88.1%), high school/technician (42.8%), urban location (73.7%), weekdays (95.3%), and daytime hours (85.5%). Factors related to electrical burns in the occupational setting were males, middle adulthood, high school/technician, Thursday, and daytime hours. Otherwise, factors related to electrical burns in the non-occupational setting were early childhood, primary school, urban location, and weekends. Both settings pose a risk of injuries to individuals. We have identified sociodemographic factors related to these injuries in both occupational and non-occupational settings, which could aid in preventing damages and long-term complications, especially among vulnerable subgroups such as determined above.
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BACKGROUND: This study aimed to assess the clinical epidemiological characteristics of children with electrical injuries and discuss the countermeasures for the prevention of electrical injuries in children. METHODS: The children with electrical injuries were grouped according to whether or not they were admitted to the hospital for treatment into inpatient and outpatient groups. Clinical data such as gender, causes of injury and injury-causing voltage distribution in different age groups were analyzed. The factors affecting hospitalization were subjected to χ2 test, Kruskal-Wallis H test, and logistic regression analysis. RESULTS: A total of 321 children were included with 37 divided into inpatient group and 284 divided into outpatient group. The incidence of electrical injuries was highest in children ≤6 years old and in the summer. There were significantly different in gender, place of occurrence, cause of injury and injury-causing voltage between the two groups (p < 0.05). Injury-causing voltage is an independent risk factor affecting hospitalization of children with electrical injuries (OR = 0.116, 95 %CI = 0.040-0.334, p = 0.000). In children ≤6 years old, boys suffered electrical injuries more frequently than girls; battery powered vehicle (47.53 %) was primarily the cause of injury; most of the patients (64.64 %) were exposed to low voltage below 100 Vs, mainly in the case of adolescent children. CONCLUSION: Male preschoolers accounted for the majority of electrical injury cases, and these accidents mostly happened in household electrical appliances and household battery cars. Overall, it is necessary to improve family electrical safety education and reinforce protective measures against electric injury to children.
Subject(s)
Electric Injuries , Hospitalization , Humans , Male , Female , Child, Preschool , Child , Retrospective Studies , Electric Injuries/epidemiology , Incidence , Hospitalization/statistics & numerical data , Risk Factors , Adolescent , Infant , China/epidemiology , Accidents, Home/prevention & control , Accidents, Home/statistics & numerical data , Age Distribution , Sex Distribution , Burns, Electric/epidemiology , Burns, Electric/prevention & control , Seasons , Electric Power SuppliesABSTRACT
INTRODUCTION: Electrical injuries can be devastating, and data is lacking in low-resource settings. We aimed to identify predictors of mortality following electrical and lightning injuries (ELI) in Malawi. METHODS: We performed a retrospective observational study of patients presenting with ELI and burn injuries at a tertiary hospital in Malawi from 2011 to 2020. Outcomes were compared and predictors of mortality were modeled. RESULTS: A total of 382 ELI and 6371 burn patients were included. The mean ages for ELI and burn groups were 24 ± 14 and 11 ± 14 years, respectively (p < 0.01). Most patients were injured at home (91% in the burn group versus 51% in the ELI group, p < 0.01). The crude mortality rate in the ELI group was 28%, compared to 12% in the burn group (p < 0.01). On multivariate logistic regression, predictors of mortality included ELI (odds ratio [OR] 13.3, 95% confidence interval [CI] 7.2-24.5) and total body surface area burned (OR 1.1, 95% CI 1.1-1.1). Predicted mortality for ELI has increased over time (p = 0.05). CONCLUSIONS: ELI confers more than 13 times higher odds of mortality than burn injuries in Malawi, with mortality risk increasing over time. More efforts are needed to prevent electrical hazards and implement timely interventions for patients with ELI.
Subject(s)
Burns , Electric Injuries , Lightning Injuries , Humans , Lightning Injuries/epidemiology , Malawi/epidemiology , Electric Injuries/epidemiology , Retrospective StudiesABSTRACT
PURPOSE: Over the years, many cases of electric cataract related to severe electrical injuries have been reported. Most have been cases where the entrance or exit point of the current was on the skull or near the eyes. Still, cases of cataract have been reported where an electric current has passed through the body between two contact points remote from the eyes. This study investigates whether persons exposed to an electric current develop cataracts in the subsequent years. METHODS: We identified 14 112 persons who had received electrical injuries in two Danish registries. We matched these with patients partly with dislocation/sprain injuries and partly with persons from the workforce from the same occupation using year of accident, sex and age as matching variables in a prospective, matched-cohort design. We identified cataract as outcome (DH25, DH26 and DH28) in the Danish National Patient Registry. The associations were analysed using conditional Cox and logistic regression. RESULTS: We did not identify an increased risk of cataract following electrical injury compared to matched controls. CONCLUSION: A review of the literature clearly substantiates the occurrence of electric cataract as a consequence of electric current coming in contact with a point on the skull or near the eye. However, our results indicate that electric cataract is not a delayed-onset effect of electrical injury, in general, and do not suggest a need for cataract screening in all cases of electrical injury.
Subject(s)
Cataract Extraction , Cataract , Electric Injuries , Humans , Cataract Extraction/adverse effects , Cohort Studies , Prospective Studies , Cataract/etiology , Cataract/complications , Electric Injuries/complicationsABSTRACT
This descriptive cross-sectional study aimed to evaluate electrocardiography (ECG) changes in patients with electrical burn injury and determine their predictive extent during hospitalization. The study population consisted of all patients with electrical injury admitted to Velayat Hospital, Rasht, Iran, during 2007-2019. The ECG information of all patients assessed by a cardiologist in terms of dysrhythmic and ischemic changes at the time of admission, demographic information including age, gender, voltage, the severity and path of the current, and degree of burn were recorded in the relevant checklist. The data were analyzed using the SPSS software version 18 (IBM, USA). Out of 192 studied patients, 183 (95%) were male, and the mean age of patients was 32 years. The ECGs of 167 patients were normal (86%), 13 cases had arrhythmia (6.7%), and 12 individuals had ischemia (6.2%). Arrhythmic and ischemic abnormalities in the ECGs of patients had no predictive value during hospitalization (P<0.05). Heart injury caused by electrical injury may be deadly in some cases, and it can be complicated to save the patient. Moreover, the predictive value of ECG in predicting the consequences and duration of hospitalization is weak.
Cette étude cas-témoin avait pour but d'évaluer les changements électrocardiographiques (ECG) observés chez des électrisés et leur valeur prédictive d'anomalies survenant durant l'hospitalisation. Elle concernait tous les électrisés admis à l'hôpital Velayat de Rasht (Iran) entre 2007 et 2019. Les données ECG (rythmiques et ischémiques) ont été analysées par un cardiologue. Nous avions en outre relevé l'âge, le sexe, le voltage, le trajet supposé du courant et les caractéristiques des brûlures, analysés ensuite avec SSPS 18 (IBM, USA). Cent quatre- vingt- trois (95%) des 192 patients étaient des hommes, âgés en moyenne de 35 ans. Cent soixante- sept (86%) ECG étaient normaux, 13 (6,7%) étaient arythmiques et 12 (6,2%) ischémiques, ces anomalies n'étant pas prédictives d'une récidive durant l'hospitalisation (p<0,05). Les conséquences myocardiques d'une électrisation peuvent être mortelles et il est parfois difficile de sauver le patient. Cependant, l'ECG initial ne renseigne pas sur les anomalies subséquentes éventuelles.
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We report a Case of a medical professional, with a very good knowledge of emergency medical devices, who committed suicide using defibrillator pads to electrocute. The decedent attached the defibrillator pads in the standard position on his chest and manually connected the terminals to an extension cord through an additional switching device. When he switched on the device, electricity passed through his heart. The autopsy showed attached defibrillator pads and severe skin burns beneath it. Scene findings were consistent with suicide. The cause of death was electrocution and manner of death was suicide. Suicide by electrocution is uncommon and suicide by electrocution using defibrillator pads has not been reported in English literature.
Subject(s)
Defibrillators , Electric Injuries/etiology , Suicide , Fatal Outcome , Humans , Male , Middle AgedABSTRACT
BACKGROUND: High voltage (>1000 V) electric injuries (HVEI) are rare, and dreaded due to profound myonecrosis and fatal arrhythmias. Trauma Centres are well equipped for acute and definitive treatment of injuries. Paucity of burn centres in Himalayan belt make trauma centres a prudent choice for management of HVEIs. We share our experience of HVEIs managed at our Level 1 Trauma Centre. METHODS: Study conducted at All India Institute of Medical Sciences, Rishikesh. Patients enrolled from prospectively maintained Trauma Registry. HVEI defined as an electrical shock from a source running current of or more than 1000 Volts. All patients admitted to department of Trauma Surgery with diagnosis of HVEIs, over 17 months (May 2019-Sept 2020) included. Demographics, clinical course, morbidity and management noted. Data is presented descriptively. RESULTS: Prevalence of HVEIs was 0.5% (n=8) among all trauma admissions; all patients were males with median age 25 years. Mode of injury accidental in 6 (75%). Seven patients (87.5%) had entry points in the upper extremity. All patients suffered thermal burns (median BSA 11%). Three patients (37.5%) had secondary fall, no concomitant injury found. Urine myoglobin & creatine kinase measured in all patients. No dysrhythmias detected in index or follow up ECGs. Four patients required emergent escharotomy, four underwent amputation. There was a median of 3 procedures per patient. Fasciotomy (n=6) and grafting (n=3) were commonest operative procedures. Multisystem involvement was seen in 3 patients. In-hospital mortality nil. CONCLUSIONS: HVEIs are rare injuries, predominantly affecting upper extremity of young males. Amputation rates approach 50% despite expeditious surgical management of extremity burn due to progressive myonecrosis. Creatine kinase and urine myoglobin did not correlate with renal failure; ECG monitoring wasn't advantageous in patients with normal index ECG in our study. Modest BSA doesnot rule out visceral damage. Delayed hollow viscus perforation is a possibility in HVEIs involving parietal wall. Vocational loss is common due to high amputation rates of affected extremity, most commonly upper limb. Trauma team is well trained to provide acute, definitive and intensive care, and level I trauma centres with their integrated services are well suited to manage victims of HVEIs in LMICs.
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INTRODUCTION AND IMPORTANCE: Low voltage electrical injuries (less than 1000 V) can produce enough tetany to cause fractures, usually of the upper extremities. Simultaneous bilateral fractures of the femoral neck are an extremely rare occurrence. It is even more uncommon for a young healthy male to suffer significant fractures from a low voltage injury. CASE PRESENTATION: A 25-year-old male attempted suicide by filling a bathtub with water and getting into it prior to dropping a blender into the water. He experienced full body convulsions but remained awake throughout the entire event. In the trauma bay his primary complaints were bilateral hip pain and back pain, without neurologic deficit. Radiological studies confirmed bilateral sub-capital femur fractures and thoracic vertebral fractures (compression fractures of T3, T4, T5, T6, T7, T9, and T11). The patient underwent bilateral open reduction and internal fixation (ORIF) of the femurs, while the spine fractures were treated with a thoracic-lumbar-sacral orthosis TLSO brace. CLINICAL DISCUSSION: Low voltage electrical injury is more likely to lead to fractures in patients with chronic renal failure and metabolic conditions such as hypocalcemia, osetomalacia, and osteoporosis. Fractures after low voltage electrical injury are extremely uncommon and a high suspicion for these injuries should be maintained because if missed there is a high risk of morbidity and mortality. CONCLUSION: We present a rare case of low voltage electrical injury by 120 V from a domestic US power supply, amplified by water conduction resulting in bilateral femoral neck fractures and vertebral body fractures.
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Abstract Contact electrical burns are more severe than other forms of contact burn injury. Moreover, treatment of hand burns is an important therapeutic challenge. We present a 17 year-old female of low voltage electric hand injury, admitted 5 days after injury. The patient was treated with autologous platelet rich plasma, porcine dermis heterograft and partial autologous skin graft, all of them with hyperbaric oxygen therapy (HBOT) at 1.45 ATA ≈100% O2 like adjuvant therapy. Good evolution and acceptable aesthetic results were reported. Although more studies are required, we suggest that multi-therapeutic approach could be effective in treatment for electric burns in hands.
Resumen Las quemaduras eléctricas por contacto son más graves que otras formas de quemaduras. Además, el tratamiento de las mismas en las manos es un importante desafío terapéutico. Presentamos el caso de una mujer de 17 años de edad con lesión en la mano por quemadura por electricidad de baja tensión. Fue ingresada 5 días después de la lesión y tratada con plasma rico en plaquetas autólogo, heteroinjerto de dermis porcina e injerto de piel autólogo parcial, todo con oxigenoterapia hiperbárica (TOHB) a 1.45 ATA ≈100% O2 como terapia adyuvante. Tuvo buena evolución y resultados estéticos aceptables. Aunque se requieren más estudios, sugerimos que el enfoque multi-terapéutico podría ser eficaz en el tratamiento de las quemaduras eléctricas en las manos.
Subject(s)
Humans , Animals , Female , Adolescent , Burns/therapy , Burns, Electric/therapy , Platelet-Rich Plasma , Hyperbaric Oxygenation , Swine , Skin TransplantationABSTRACT
Contact electrical burns are more severe than other forms of contact burn injury. Moreover, treatment of hand burns is an important therapeutic challenge. We present a 17 year-old female of low voltage electric hand injury, admitted 5 days after injury. The patient was treated with autologous platelet rich plasma, porcine dermis heterograft and partial autologous skin graft, all of them with hyperbaric oxygen therapy (HBOT) at 1.45 ATA "100% O2 like adjuvant therapy. Good evolution and acceptable aesthetic results were reported. Although more studies are required, we suggest that multi-therapeutic approach could be effective in treatment for electric burns in hands.
Las quemaduras eléctricas por contacto son más graves que otras formas de quemaduras. Además, el tratamiento de las mismas en las manos es un importante desafío terapéutico. Presentamos el caso de una mujer de 17 años de edad con lesión en la mano por quemadura por electricidad de baja tensión. Fue ingresada 5 días después de la lesión y tratada con plasma rico en plaquetas autólogo, heteroinjerto de dermis porcina e injerto de piel autólogo parcial, todo con oxigenoterapia hiperbárica (TOHB) a 1.45 ATA "100% O2 como terapia adyuvante. Tuvo buena evolución y resultados estéticos aceptables. Aunque se requieren más estudios, sugerimos que el enfoque multi-terapéutico podría ser eficaz en el tratamiento de las quemaduras eléctricas en las manos.
Subject(s)
Burns, Electric , Burns , Hyperbaric Oxygenation , Platelet-Rich Plasma , Adolescent , Animals , Burns/therapy , Burns, Electric/therapy , Female , Humans , Skin Transplantation , SwineABSTRACT
BACKGROUND: Many work-related fatalities happen every year in electricity distribution companies. This study was conducted to model accidents using the time series analysis and survey descriptive factors of injuries in an electricity distribution company in Tehran, Iran. METHODS: Data related to 2010 to 2017 were collected from the database of the safety department. Time series and trend analysis were used for data analyzing and anticipating the accidents up to 2022. RESULT: Most of the accidents occurred in summer. Workers' negligence was the reason for 75% of deaths. Employment type and type of injuries had a significant relationship (pâ< â0.05). CONCLUSION: The anticipating model indicated occupational injuries are going to have an increase in the future. A high rate of accidents in summer maybe because of the warm weather or insufficient skills in temporary workers. Temporary workers have no chance to work in a year like permanent workers, therefore acquisition experiences may be less in them. Based on the estimating model, management should pay attention to those sectors of the company where most of the risky activities take place. Also, training programs and using personal protective equipment can help to protect workers in hazardous conditions.
Subject(s)
Accidents, Occupational , Occupational Injuries , Electricity , Humans , Iran/epidemiology , Occupational Injuries/epidemiology , Research DesignABSTRACT
Immersion rod is a very low-cost electrical device. It is based on simple working principle and widely used in developing nations to heat water for various domestic needs. However, the literature about electrocution caused by it is nearly absent. This is despite its usage being potentially hazardous, with almost sure fatal outcome in cases of mishandling. Data was gathered from 2011 to 2020, via inquest and autopsy reports, regarding electrocution deaths related to it. 6 cases were identified. All consisted of females in domestic settings, as the unique epidemiology in stark contrast to the existing literature on electrocution fatalities worldwide. Injury patterns in a few cases resembled those typical of high voltage electrocution, in these low voltage fatalities. Characteristics of joule burns showed sub-patterns, deviant from electrocution related to other appliances and was again unreported previously. Spark burns and scalds were patterns, quite diagnostic of immersion rod fatalities. A typical pattern for a multitude of injuries in each case is brevity of this study. Injury patterns are presented as a classical guide for further growth of the literature on these types of fatalities.
Subject(s)
Accidents, Home , Electric Injuries/etiology , Heating/instrumentation , Water , Adolescent , Adult , Burns, Electric/etiology , Burns, Electric/pathology , Electric Injuries/pathology , Fatal Outcome , Female , Heating/adverse effects , Humans , Male , Middle Aged , Retrospective Studies , Shock/etiologyABSTRACT
Serious electrical injuries are rare but may have life-threatening consequences. Voltage exposure injuries are divided into low voltage injury (LVI) or high voltage injury (HVI). An LVI current can result in severe injury, depending on the length of exposure, the size of the individual, the cross-sectional area in contact with the electrical source, and environmental humidity. The authors present a 31-year-old male with accidental electrocution with low voltage current and cardiopulmonary arrest. A detailed revision by organs and systems is presented. LVI is uncommon and can occur with a variety of clinical presentations, rarely presenting with direct lung injury. Early recognition and support are the cornerstones of treatment.
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Shrinking natural habitats exposes some non-human primates to the risk of accidents associated with electrical transmission lines. We examined dead marmosets (Callithrix penicillata) collected in the region from January 2015 to April 2018 to determine the animals' cause of death and for electrocuted animals we examined the locations the animals had died as well as the configuration of the power lines at these sites. We also recorded the sex of the animal, the body region affected, and characteristics of the injuries. We diagnosed electrocutions in 11% (n = 34) of the marmosets studied. Most of the affected animals were male (n = 22) with single or double sites of injury on the limbs. Animals were injured in urban (n = 26) and peri-urban (n = 8) areas on lower-voltage alternate current lines, and we detected no seasonality or hotspots of electrocution. Our findings suggest that movement along transmission lines composed of bundled conductors is a major factor in electrocutions of marmosets in the Federal District and surrounding areas. The planning of electrical power grid infrastructure should consider arboreal primates to prevent electrocutions.
Subject(s)
Callithrix/injuries , Electric Injuries/etiology , Electric Injuries/veterinary , Animals , Brazil , Cities , Electric Injuries/mortality , Electric Wiring , Female , MaleABSTRACT
BACKGROUND: Electricity is a necessity for humans to carry out their daily activities, wherein modern times there are many human life support devices require electricity that makes humans depend on their existence, it cannot be denied that electricity is the energy needed by humans in everything that supports human activities, that increased injury due to electric shocks such as the cardiovascular system, nervous system, respiratory system, cutaneous injuries, burns, neurotransmitter system and death. Psychiatric disorders such as psychosis, mania, depression, post-traumatic stress disorder, conversion disorder, adjustment disorders and schizophrenia have been reported as diseases triggered by electrical injuries. CASE REPORT: This study reports cases of electrical injuries that cause psychotic symptoms such as schizophrenia. After low voltage electrical injury. A 20 years old male, Malay, Indonesian, graduated from high school, worked, unmarried, a history of psychiatric disorders was not found, family history of experiencing the same disease was not found. Reported to have suffered an injury due to electricity twice the first injury occurred, and caused a change in behaviour and emotions, and the second injury caused obvious psychotic symptoms, aggressive behaviour and mood enhancement. A brief review of the literature on the occurrence of psychiatric disorders in these injuries is also presented. CONCLUSION: Electrical injuries can cause sequelae such as psychotic disorders, the increased mood has occurred after an electrical injury in someone without prior mood disorders and personality. This is associated with circulatory hormone changes that occur in the hippocampus.
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BACKGROUND: Transvestites are often excluded and even get discriminatory treatment. People feel that the values adopted are contrary to the existence of transvestites amid society. The community generally has a normative structure; a man becomes a man with his masculinity and a woman is returned to women with her femininity and is positioned to pair up. CASE REPORT: We found depressed patients in a transvestite, 21-year-old male, a Malay tribe with complaints of loss of self-confidence, lack of cheerfulness, lack of enthusiasm, easily tired and unable to sleep. Feeling family and community cannot accept their conditions. Mockery, ridicule and satire by citizens must be received every day by patients and families because the patient is a transvestite. CONCLUSION: As a conclusion from this case report that the attitude of the dominant community isolates transvestites, there is still much discriminative behaviour and harassing transvestites so that self-esteem decreases, loss of interest even until the occurrence of depression in transvestites.
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OBJECTIVES: To date, no research has investigated the association between cardiac complication and electrical injury; hence, we aimed to assess the consequences and relating factors of cardiac complications from electrical injuries in South Korea. DESIGN: Retrospective single-centre study. PARTICIPANTS: 721 patients who had electrical injury-related admission during 2007-2017. An electronic medical record system was used to extract records of patients admitted for electrical injury treatment. RESULTS: Cardiac complications included abnormal parameters of myocardial damage, abnormal regional wall motion detected via echocardiogram, dysrhythmia (eg, bradycardia, atrial flutter/fibrillation) and ventricular tachycardia or fibrillation. Overall, 107 patients (14.8%) experienced cardiac complications. The average admission duration and intensive care unit stay duration were significantly longer in patients with cardiac complications than in those without them (75.0±45.3 vs 56.6±48.0 days and 19.3±24.1 vs 10.4±15.5 days, respectively, p<0.01 for both). Of the total cardiac cases, 72.9% had Troponin I elevation, 3.7% had regional wall motion abnormality, and 5.6% had atrial flutter/fibrillation. Overall, seven patients from the cardiac complication group and three patients from the control group died (p=0.01). All deaths occurred within 32 days, and the most common cause of death was septic shock. Total body surface area (TBSA) was only positively related factor to cardiac complications. CONCLUSION: This study is the first in South Korea to reveal that electrical accident patients with cardiac complications experience poorer in-hospital prognosis, and TBSA was the only risk factor of cardiac complications. And initial treatment for infection and inflammations could be important in electrical injury.
Subject(s)
Arrhythmias, Cardiac/etiology , Electric Injuries/complications , Heart/physiopathology , Shock, Septic/etiology , Adult , Cause of Death , Echocardiography , Electric Injuries/mortality , Electric Injuries/therapy , Female , Humans , Intensive Care Units , Logistic Models , Male , Middle Aged , Prognosis , Republic of Korea , Retrospective StudiesABSTRACT
OBJECTIVE: To determine acute and long-term clinical, neuropsychological, and return-to-work (RTW) effects of electrical injuries (EIs). This study aims to further contrast sequelae between low-voltage and high-voltage injuries (LVIs and HVIs). We hypothesise that all EIs will result in substantial adverse effects during both phases of management, with HVIs contributing to greater rates of sequelae. DESIGN: Retrospective cohort study evaluating EI admissions between 1998 and 2015. SETTING: Provincial burn centre and rehabilitation hospital specialising in EI management. PARTICIPANTS: All EI admissions were reviewed for acute clinical outcomes (n=207). For long-term outcomes, rehabilitation patients, who were referred from the burn centre (n=63) or other burn units across the province (n=65), were screened for inclusion. Six patients were excluded due to pre-existing psychiatric conditions. This cohort (n=122) was assessed for long-term outcomes. Median time to first and last follow-up were 201 (68-766) and 980 (391-1409) days, respectively. OUTCOME MEASURES: Acute and long-term clinical, neuropsychological and RTW sequelae. RESULTS: Acute clinical complications included infections (14%) and amputations (13%). HVIs resulted in greater rates of these complications, including compartment syndrome (16% vs 4%, p=0.007) and rhabdomyolysis (12% vs 0%, p<0.001). Rates of acute neuropsychological sequelae were similar between voltage groups. Long-term outcomes were dominated by insomnia (68%), anxiety (62%), post-traumatic stress disorder (33%) and major depressive disorder (25%). Sleep difficulties (67%) were common following HVIs, while the LVI group most frequently experienced sleep difficulties (70%) and anxiety (70%). Ninety work-related EIs were available for RTW analysis. Sixty-one per cent returned to their preinjury employment and 19% were unable to return to any form of work. RTW rates were similar when compared between voltage groups. CONCLUSIONS: This is the first investigation to determine acute and long-term patient outcomes post-EI as a continuum. Findings highlight substantial rates of neuropsychological and social sequelae, regardless of voltage. Specialised and individualised early interventions, including screening for mental health concerns, are imperative to improvingoutcomes of EI patients.