[Epidemiology, initial management and analysis of morbidity-mortality of severe burn patient]. / Epidemiología, manejo inicial y análisisde morbimortalidad del gran quemado.

OBJECTIVE: Describe the epidemiological characteristics of severe burn patients and analyze the factors related with morbidity-mortality. DESIGN AND SCOPE: Observational, retrospective study of patients admitted to an intensive care unit of a level III hospital due to severe burns from January 1998 to December 2004. PATIENTS: 59 patients with criteria of "severe burn" and expected stay in ICU greater than three days. MAIN ENDPOINTS OF INTEREST: We studied epidemiological endpoints of this type of patients, diagnosis and initial treatment, early complications and morbidity-mortality. RESULTS: The burned body surface was 41% +/- 25% and age 49 +/- 21 years. Patients remained hospitalized in ICU for a median of 4 days (interquartile range: 2-19). A total of 78% of the patients needed mechanical ventilation, 47% had some infection during admission and 28% developed acute kidney failure during the first week. Mortality in the ICU was 42%. Endpoints associated independently with a significant increase of mortality were burned body surface greater than 35% (OR 1.08; 95% CI: 1.03-1.12) and development of kidney failure (OR 5.47; 95% CI: 2.02 -8.93). CONCLUSIONS: Mortality of these patients is very high and is conditioned largely by initial care. Percentage of burned body surface (BBS) and kidney failure entails greater mortality in our series.

Epidemiología, manejo inicial y análisisde morbimortalidad del gran quemado / Epidemiology, initial managementand analysis of morbidity-mortalityof severe burn patient

Objetivo. Describir las características epidemiológicas de los pacientes quemados graves y analizar los factores relacionados con la morbimortalidad. Diseño y ámbito. Estudio observacional retrospectivo de los pacientes ingresados en una Unidad de Cuidados Intensivos (UCI) de un hospital de nivel III por quemaduras graves, entre enero de 1998 y diciembre de 2004. Pacientes. Cincuenta y nueve pacientes con criterios de «gran quemado» y estancia esperada en UCI superior a tres días. Principales variables de interés. Estudiamos variables epidemiológicas de este tipo de pacientes, diagnóstico y manejo inicial, complicaciones precoces y morbimortalidad. Resultados. La superficie corporal quemada fue del 41 ± 25% y la edad 49 ± 21 años. Los pacientes permanecieron ingresados en la UCI durante una mediana de 4 días (rango intercuartil: 2-19). Un 78% de los pacientes necesitaron ventilación mecánica, un 47% presentó alguna infección durante el ingreso, y un 28% desarrolló insuficiencia renal aguda durante la primera semana. La mortalidad en UCI fue del 42%. Las variables asociadas de manera independiente con un aumento significativo de la mortalidad fueron la superficie corporal quemada superior al 35% (OR 1,08; IC 95%: 1,03-1,12) y el desarrollo de insuficiencia renal (OR 5,47; IC 95%: 2,02-8,93). Conclusiones. La mortalidad de estos pacientes es muy alta, y viene condicionada, en gran parte, por la asistencia inicial. El porcentaje de superficie corporal quemada y el fallo renal conllevan mayor mortalidad en nuestra serie

Objective. Describe the epidemiological characteristics of severe burn patients and analyze the factors related with morbidity-mortality. Design and scope. Observational, retrospective study of patients admitted to an intensive care unit of a level III hospital due to severe burns from January 1998 to December 2004. Patients. 59 patients with criteria of «severe burn» and expected stay in ICU greater than three days. Main endpoints of interest. We studied epidemiological endpoints of this type of patients, diagnosis and initial treatment, early complications and morbidity-mortality. Results. The burned body surface was 41% ± 25% and age 49 ± 21 years. Patients remained hospitalized in ICU for a median of 4 days (interquartile range: 2-19). A total of 78% of the patients needed mechanical ventilation, 47% had some infection during admission and 28% developed acute kidney failure during the first week. Mortality in the ICU was 42%. Endpoints associated independently with a significant increase of mortality were burned body surface greater than 35% (OR 1.08; 95% CI: 1.03-1.12) and development of kidney failure (OR 5.47; 95% CI: 2.02 -8.93). Conclusions. Mortality of these patients is very high and is conditioned largely by initial care. Percentage of burned body surface (BBS) and kidney failure entails greater mortality in our series