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1.
Cancer Sci ; 110(11): 3573-3583, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31505087

RESUMO

This study determined individual optimal amrubicin doses for Japanese patients with lung cancer after platinum-based treatment. We carried out population pharmacokinetic and pharmacodynamic modeling incorporating gene polymorphisms of metabolizing enzymes and transporters. Fifty patients with lung cancer, who were given 35-40 mg/m2 amrubicin on days 1-3 every 3-4 weeks, were enrolled. Mechanism-based modeling described relationships between the pharmacokinetics of amrubicin and absolute neutrophil counts. A population pharmacokinetic and pharmacodynamic model was developed for amrubicin and amrubicinol (active metabolite), connected by a delay compartment. The final model incorporated body surface area as a covariate of amrubicin and amrubicinol clearance and distribution volume. SLC28A3 single nucleotide polymorphism (rs7853758) was also incorporated as a constant covariate of the delay compartment of amrubicinol. Performance status was considered a covariate of pharmacokinetic (amrubicinol clearance) and pharmacodynamic (mean maturation time) parameters. Twenty-nine patients with grade 4 neutropenia showed higher amrubicinol area under the plasma concentration-time curve from 0 to 72 hours (AUC0-72 , P = .01) and shorter overall survival periods than other patients did (P = .01). Using the final population pharmacokinetic and pharmacodynamic model, median optimal dose to prevent grade 4 neutropenia aggravation was estimated at 22 (range, 8-40) mg/m2 for these 29 patients. We clarified correlations between area under the plasma concentration-time curve from 0 to 72 hours of amrubicinol and severity of neutropenia and survival of patients given amrubicin after platinum chemotherapy. This analysis revealed important amrubicin pharmacokinetic-pharmacodynamic covariates and provided useful information to predict patients who would require prophylactic granulocyte colony stimulating factor.


Assuntos
Antraciclinas/administração & dosagem , Antineoplásicos/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Neutropenia/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Antraciclinas/farmacocinética , Antineoplásicos/farmacocinética , Área Sob a Curva , Grupo com Ancestrais do Continente Asiático , Superfície Corporal , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Esquema de Medicação , Feminino , Humanos , Japão , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/mortalidade , Masculino , Proteínas de Membrana Transportadoras/genética , Pessoa de Meia-Idade , Neutropenia/induzido quimicamente , Neutropenia/metabolismo , Polimorfismo de Nucleotídeo Único , Estudos Prospectivos , Índice de Gravidade de Doença
2.
J Craniofac Surg ; 30(8): 2551-2554, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31449203

RESUMO

BACKGROUND: Facial burns have lasting physical and psychological effects on pediatric patients. Proper management to minimize morbidities challenges reconstructive surgeons. New technologies allowed the development of skin substitutes such as amniotic and chorionic membranes, yet the use of these skin dressings and their impact on burn outcomes have not been sufficiently studied to guide practices. The objective of this study is to report on the outcomes of dehydrated amniotic membrane as a biologic skin dressing in pediatric facial burn injury compared to cadaveric allografts. METHODS: Retrospective review of data collected from our institutional burn registry from 2012 to 2016. The study population included patients younger than 16 years with facial burns. Patients between 2012 and 2014 received cadaveric allografts, whereas during 2015 to 2016 patients received dehydrated human amniotic/chorionic membrane as standard treatment. Demographic characteristics and outcome measures were compared between the 2 groups. RESULTS: Included 30 patients with a mean age of 3.7 years and with an average total body surface area burn of 6.8% (2%-27%). Mean injury severity scores did not significantly differ between both groups, 1.8 in amniotic group versus 2.3 in cadaveric skin group (P > 0.05). There were 4 complications (3 hypertrophic scars and 1 wound infection) in the cadaveric allografts group versus no complications in the amniotic membrane group (P < 0.05). CONCLUSION: Dehydrated amniotic/chorionic membrane wound dressings are a safe alternative to cadaveric allografts in treating pediatric partial thickness facial burns.


Assuntos
Âmnio/cirurgia , Queimaduras/cirurgia , Traumatismos Faciais/cirurgia , Bandagens , Curativos Biológicos , Superfície Corporal , Pré-Escolar , Cicatriz Hipertrófica/cirurgia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Pele , Transplante de Pele , Pele Artificial , Transplante Homólogo
3.
Nursing ; 49(9): 51-54, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31436723

RESUMO

This article reviews the method of measure known as body surface area (BSA) and discusses when and why BSA calculations are used. Techniques for BSA calculation are also described.


Assuntos
Superfície Corporal , Cálculos da Dosagem de Medicamento , Enfermagem , Índice de Massa Corporal , Humanos
4.
J Forensic Leg Med ; 67: 19-23, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31376649

RESUMO

In cases of death due to burn injury, it may be of great medico-legal importance to determine if the death is caused by fatal burn injury or due to other factors related to treatment. Therefore, this study aimed to investigate early predictors of mortality in patients with thermal burns admitted to Burn Unit, Ain Shams University Hospitals during a period of one year (2011). The study included 152 cases, mortalities represented 20.4% of the included cases (31 cases). Binary logistic regression analysis showed that, total body surface area (TBSA) of the burns and APACHE III score were significant predictors of mortality. This model resulted in accurate classification of 95.9% of the cases. Further multi-centric studies on larger sample sizes are recommended to validate the results of this study. Also, it is important to study the effect of co-morbidities as confounding factors on the prediction of mortality in patients with thermal burns.


Assuntos
Queimaduras/mortalidade , APACHE , Adolescente , Adulto , Superfície Corporal , Unidades de Queimados , Criança , Egito/epidemiologia , Feminino , Hospitais Universitários , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
6.
J Am Acad Dermatol ; 81(3): 686-693, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31195022

RESUMO

BACKGROUND: Sepsis is the main cause of death in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). OBJECTIVES: Our aim was to identify admission risk factors predictive of bacteremia and the accompanying clinical or biochemical markers associated with positive blood cultures. METHODS: A retrospective cohort study over a 14-year period (2003-2016) was performed. RESULTS: The study included 176 patients with SJS (n = 59), SJS-TEN overlap (n = 51), and TEN (n = 66). During hospitalization, bacteremia developed in 52 patients (29.5%), who experienced poorer outcomes, including higher intensive care unit admission (P < .0005), longer length of stay (P < .0005), and higher mortality (P < .0005). There were 112 episodes of bacteremia, and isolates included Acinetobacter baumannii (27.7%, n = 31) and Staphylococcus aureus (21.4%, n = 24). On multivariate analysis, clinical factors present at admission that were predictive of bacteremia included hemoglobin ≤10 g/dL (odds ratio [OR] 2.4, confidence interval [CI] 2.2-2.6), existing cardiovascular disease (OR 2.10, CI 2.0-2.3), and body surface area involvement ≥10% (OR 14.3, CI 13.4-15.2). The Bacteremia Risk Score was constructed with good calibration. Hypothermia (P = .03) and procalcitonin ≥1 µg/L (P = .02) concurrent with blood culture sampling were predictive of blood culture positivity. LIMITATIONS: This is a retrospective study performed in a reference center. CONCLUSION: Hemoglobin ≤10 g/dL, cardiovascular disease, and body surface area involvement ≥10% on admission were risk factors for bacteremia. Hypothermia and elevated procalcitonin are useful markers for the timely detection of bacteremia.


Assuntos
Bacteriemia/diagnóstico , Bactérias/isolamento & purificação , Hipotermia/diagnóstico , Índice de Gravidade de Doença , Síndrome de Stevens-Johnson/complicações , Adulto , Idoso , Bacteriemia/sangue , Bacteriemia/etiologia , Hemocultura , Superfície Corporal , Feminino , Hemoglobinas/análise , Humanos , Hipotermia/sangue , Hipotermia/etiologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pró-Calcitonina/sangue , Prognóstico , Estudos Retrospectivos , Medição de Risco/métodos , Fatores de Risco , Singapura , Síndrome de Stevens-Johnson/sangue , Síndrome de Stevens-Johnson/diagnóstico
9.
BMC Pregnancy Childbirth ; 19(1): 209, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226954

RESUMO

BACKGROUND: Vitamin D deficiency during pregnancy carries potential threat to fetal well being. Natural conversion of vitamin D in the skin can be facilitated by direct ultra violet B (UVB) radiation, but the effect is reduced by wearing umbrellas, clothes, or sunblock cream. Muslim women wear hijab that allows only face and hands to be seen. With increasing proportion of muslim women wearing hijab and the lack of vitamin D fortification and fish consumption in Indonesia, it poses a problem for vitamin D deficiency among pregnant women. This study aimed at finding the best timing of UVB exposure and the duration of exposure which can be suggested to prevent vitamin D deficiency among pregnant women, for those wearing hijab or not. METHODS: This study recruited 304 pregnant women in the first trimester, 75-76 women from 4 cities of the most populated province, West Java, Indonesia which represented 70-80% percent of pregnancy per year. A 3-day notes on duration, time and type of outdoor activity and the clothing wore by the women were collected. UVB intensity radiation were obtained. Calculation on body surface area exposed to direct UVB radiation and UVB radiation intensity were done. Measurement of vitamin D level in sera were done on the same week. RESULTS: The median of maternal sera vitamin D level was 13.6 ng/mL and the mean exposed area was around 0.48 m2 or 18.59% of total body surface area. Radiation intensity reached its peak around 10.00 and 13.00, but the mean duration of exposure to UVB during this window was lower than expected. Significant correlation was found between maternal sera vitamin D level and exposed body surface area (r = 0.36, p < 0.002) or percentage of exposed body surface (r = 0.39, p < 0.001) and radiation intensity (r = 0.15, p = 0.029). Further analysis showed that duration of exposure to UVB should be longer for pregnant women wearing hijab as compared to women without hijab. CONCLUSION: This study suggested that the best timing to get UVB exposure was between 10.00-13.00, with longer duration for women wearing hijab (64.5 vs 37.5 min) of continuous exposure per day.


Assuntos
Vestuário , Complicações na Gravidez/prevenção & controle , Exposição à Radiação , Raios Ultravioleta , Deficiência de Vitamina D/prevenção & controle , Adulto , Superfície Corporal , Feminino , Humanos , Indonésia , Gravidez , Complicações na Gravidez/sangue , Fatores de Tempo , Clima Tropical , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Adulto Jovem
10.
Dermatology ; 235(4): 348-354, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31141807

RESUMO

BACKGROUND/AIMS: In the treat-to-target era, psoriasis disease activity measures that can be easily performed in routine clinical practice are needed. This retrospective pooled analysis explored cutoff values of the product of the 5-point Investigator's Global Assessment and percentage of affected body surface area (IGA × BSA) correlating with achievement of minimal disease activity (MDA). METHODS: Post hoc analysis of the phase 3 clinical trials ERASURE, FIXTURE, FEATURE, and JUNCTURE was conducted to determine associations between IGA × BSA and 2 MDA definitions (Psoriasis Area and Severity Index [PASI] 90 and Dermatology Life Quality Index [DLQI] 0/1, or PASI score ≤1 or BSA <3%) in patients with moderate-to-severe psoriasis receiving secukinumab 300 mg. For each definition of MDA, a range of possible cutoff values of IGA × BSA was examined at each time point. The optimal cutoff value was determined using Youden index (YI), calculated as (sensitivity + specificity - 1). RESULTS: For MDA defined as PASI 90 and DLQI 0/1, optimal IGA × BSA cutoffs were 2.10 at week 12 (YI, 0.60; sensitivity, 0.78; specificity, 0.82), 1.02 at week 24 (YI, 0.55; sensitivity, 0.73; specificity, 0.82), and 1.00 at week 52 (YI, 0.65; sensitivity, 0.79; specificity, 0.86). For MDA defined as PASI score ≤1 or BSA <3%, optimal IGA × BSA cutoffs were 2.98 at week 12 (YI, 0.91; sensitivity, 0.99; specificity, 0.92), 2.80 at week 24 (YI, 0.94; sensitivity, 0.99; specificity, 0.95), and 3.00 at week 52 (YI, 0.96; sensitivity, 1.00; specificity, 0.96). CONCLUSION: IGA × BSA could be a valid measure highly associated with achievement of MDA.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Superfície Corporal , Fármacos Dermatológicos/uso terapêutico , Psoríase/diagnóstico , Ensaios Clínicos como Assunto , Humanos , Psoríase/tratamento farmacológico , Estudos Retrospectivos , Índice de Gravidade de Doença
11.
PLoS One ; 14(5): e0217637, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31141818

RESUMO

BACKGROUND: Left ventricular mass normalization for body size is recommended, but a question remains: what is the best body size variable for this normalization-body surface area, height or lean body mass computed based on a predictive equation? Since body surface area and computed lean body mass are derivatives of body mass, normalizing for them may result in underestimation of left ventricular mass in overweight children. The aim of this study is to indicate which of the body size variables normalize left ventricular mass without underestimating it in overweight children. METHODS: Left ventricular mass assessed by echocardiography, height and body mass were collected for 464 healthy boys, 5-18 years old. Lean body mass and body surface area were calculated. Left ventricular mass z-scores computed based on reference data, developed for height, body surface area and lean body mass, were compared between overweight and non-overweight children. The next step was a comparison of paired samples of expected left ventricular mass, estimated for each normalizing variable based on two allometric equations-the first developed for overweight children, the second for children of normal body mass. RESULTS: The mean of left ventricular mass z-scores is higher in overweight children compared to non-overweight children for normative data based on height (0.36 vs. 0.00) and lower for normative data based on body surface area (-0.64 vs. 0.00). Left ventricular mass estimated normalizing for height, based on the equation for overweight children, is higher in overweight children (128.12 vs. 118.40); however, masses estimated normalizing for body surface area and lean body mass, based on equations for overweight children, are lower in overweight children (109.71 vs. 122.08 and 118.46 vs. 120.56, respectively). CONCLUSION: Normalization for body surface area and for computed lean body mass, but not for height, underestimates left ventricular mass in overweight children.


Assuntos
Coração/fisiopatologia , Hipertrofia Ventricular Esquerda/epidemiologia , Sobrepeso/epidemiologia , Obesidade Pediátrica/epidemiologia , Adolescente , Composição Corporal/fisiologia , Estatura , Índice de Massa Corporal , Tamanho Corporal , Superfície Corporal , Criança , Pré-Escolar , Ecocardiografia , Gorduras/metabolismo , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Tamanho do Órgão , Sobrepeso/fisiopatologia , Obesidade Pediátrica/fisiopatologia , Valores de Referência
14.
J Pharm Pharmacol ; 71(8): 1222-1230, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31124587

RESUMO

OBJECTIVES: Cetuximab dosing is based on body surface area (BSA), an approach that is associated with significant wastage due to available vial sizes. NHS England recently introduced an alternative strategy for cetuximab dosing based on dose banding. The aim of this work was to investigate approaches to cetuximab dosing to improve its cost-effectiveness. METHODS: A simulation study using a population pharmacokinetic model was used to assess the performance of dosing strategies using exposure, probability of target attainment and cost. Two dosage regimens (500 and 400/250 mg/m2 ) were investigated; 5% and 10% dose banding, fixed and optimised dosing strategies were evaluated and compared to BSA strategy. KEY FINDINGS: The percentage of the total cost associated with wastage for the 400/250 mg/m2 regimen were 8.75%, 5.13%, 3.61%, 9.2% and 0% for BSA; 5 and 10% bands; fixed and optimal strategies, respectively. Similar results were obtained for 500 mg/m2 regimen. In comparison with BSA strategy, other strategies have comparable or improved performance. Optimised strategy showed consistent performance and ensures equal exposure and probability of target attainment. CONCLUSIONS: Cost-effectiveness of cetuximab treatment can be improved with alternative strategies by reducing wastage without compromising exposure.


Assuntos
Antineoplásicos Imunológicos/administração & dosagem , Antineoplásicos Imunológicos/farmacocinética , Cetuximab/administração & dosagem , Cetuximab/farmacocinética , Animais , Superfície Corporal , Custos e Análise de Custo/métodos , Humanos , Camundongos
15.
Niger J Clin Pract ; 22(5): 642-647, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31089018

RESUMO

Aim: We aimed to compare the epidemiological data, general characteristics, laboratory findings, and outcomes of burn patients with ≤18 and >18 years of age. By this way, we also aimed to determine the effective preventive measures appropriate for different age groups. Subjects and Methods: The data of 630 consecutive patients admitted to our hospital with 2nd or 3rd degree burn injuries were retrospectively investigated. The patients were grouped into two regarding their ages as ≤18 (group 1) and >18 (group 2) years. Data of age, gender, cause of injury, location of injury, total burn area, length of hospital stay, laboratory data, and outcome of treatment were recorded. Results: We determined that although burn injury is more common in males compared with the females, male predominance is more commonly determined in older age group than children. Extremities are most commonly affected areas in both groups. In children, the most common etiological agent was hot beverages while in older age group electrical burns, and work accidents were more common (P < 0.001). Among children, patients younger than 3 years of age were compromising 62.4% of all cases. In adult group, total burned body surface area %, operation or intensive care unit requirement, hospitalization period, blood transfusion, or fresh frozen plasma requirement and the number of patients expired were all significantly higher compared with the children. Regarding the admission laboratory data, renal and liver function tests were significantly worse in older age group. However, neutrophile percentage was significantly higher in older group which may be a sign of augmented inflammatory response. Conclusion: Especially clinicians and public health providers should be aware of the clinical findings and outcomes of burn victims in order to drive more effective preventive measures.


Assuntos
Queimaduras/epidemiologia , Queimaduras/terapia , Neutrófilos , Traumatismos Ocupacionais/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Bebidas , Superfície Corporal , Queimaduras/fisiopatologia , Queimaduras por Corrente Elétrica/epidemiologia , Criança , Pré-Escolar , Extremidades/lesões , Feminino , Humanos , Lactente , Unidades de Terapia Intensiva , Rim/fisiopatologia , Tempo de Internação , Contagem de Leucócitos , Fígado/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Turquia/epidemiologia , Adulto Jovem
17.
Burns ; 45(4): 805-817, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31031020

RESUMO

OBJECTIVES: The purpose of this study was to establish patterns in types of burns referred to the Outpatient Clinic (OP) at Vancouver General Hospital (VGH). METHODS: A 2-year retrospective chart review was conducted of patients presenting to the OP Clinic from June 1, 2016 - June 1, 2018. Data collected included: patient demographics, depth of burn, Total Body Surface Area (TBSA), anatomical location of burn, geographical location of referral, and operative versus non-operative management. RESULTS: The OP Clinic served 470 patients for burn injuries with a total of 1852 visits. Of these, 20% were follow-up visits post-admission, and 73.6% were primary referrals from the emergency department (ED) or elsewhere. The vast majority (69.6%) of burns were less than 5% TBSA. Half involved the hands (50.9%), and half were superficial dermal in depth (45.1%). A third of patients attended only one appointment with the OP Clinic before discharge and 15% did not receive any treatment. CONCLUSIONS: The results of our study demonstrate gaps in current provincial referral guidelines leading to a significant number of "unnecessary referrals." Further research could correlate the results to current provincial referral guidelines to estimate their current efficacy in practical use.


Assuntos
Traumatismos do Braço/terapia , Queimaduras/terapia , Traumatismos da Mão/terapia , Traumatismos da Perna/terapia , Ambulatório Hospitalar , Encaminhamento e Consulta/normas , Adolescente , Adulto , Assistência ao Convalescente/estatística & dados numéricos , Idoso , Assistência Ambulatorial/estatística & dados numéricos , Traumatismos do Braço/patologia , Superfície Corporal , Colúmbia Britânica , Unidades de Queimados , Queimaduras/patologia , Serviço Hospitalar de Emergência , Feminino , Clínicos Gerais , Traumatismos da Mão/patologia , Hospitalização , Humanos , Traumatismos da Perna/patologia , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Índices de Gravidade do Trauma , Adulto Jovem
18.
Burns ; 45(3): 560-566, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31018912

RESUMO

BACKGROUND: Patients with major burns covering a large total body surface area (%TBSA) fulfill all the criteria of Virchow's triad, as a sequela of their injury. This places these patients at increased risk for developing deep vein thrombosis (DVT). However, data regarding the incidence of DVT in burn patients are minimal, especially in the pediatric age group. Therefore, the aim of this study is to determine the incidence of DVT in pediatric burn patients, identify possible risk factors for developing DVT, and explore the need for prophylactic treatment. METHODS: A retrospective chart review of 95 patients admitted to our Burn Unit was conducted. We included all pediatric patients with second- and third-degree burns admitted to the unit. Exclusion criteria were adult patients, those with first-degree burns and admitted to the unit for <72h, patients discharged against medical advice, those admitted for elective reconstructive surgery, secondary admissions for non-healing/infected burns, and patients with trauma-induced skin loss. A data collection sheet was utilized. RESULTS: The total incidence of thrombosis in our population was 4.2% (DVT, 3.1%; arterial thrombosis, 1.1%). Factors significantly associated with DVT included length of hospitalization (p=0.012), central venous catheter placement (p=0.013), and %TBSA (p=0.004). Unlike adult patients, weight for age (percentile) and body mass index were not significant risk factors for DVT in our patients. CONCLUSION: Burns are a major risk factor for DVT, especially when covering large surface areas (≥40% TBSA) and combined with other factors (i.e., prolonged hospitalization and central lines). Thus, investigations for DVT and prophylactic anticoagulation should be considered for pediatric burn patients with these risk factors, even if they are asymptomatic.


Assuntos
Doenças da Aorta/epidemiologia , Queimaduras/epidemiologia , Cateteres Venosos Centrais/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Trombose Venosa/epidemiologia , Adolescente , Anticoagulantes/uso terapêutico , Aorta Torácica , Índice de Massa Corporal , Superfície Corporal , Quimioprevenção , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores de Risco , Arábia Saudita/epidemiologia , Trombose/epidemiologia , Trombose/prevenção & controle , Trombose Venosa/prevenção & controle
19.
Rev Col Bras Cir ; 46(2): e2115, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31017179

RESUMO

OBJECTIVE: to evaluate the effectiveness of the adopted strategy and the care quality for pediatric trauma in the survival of patients attended after a disaster in a city in the interior of Minas Gerais state, compared to the expected results of studies on infant mortality in major burns. METHODS: retrospective observational analysis of ten patients who were burned and transferred to a trauma reference center. We used the modified R-Baux score to estimate the expected mortality. We compared the expected mortality predicted by R-Baux score and the actual mortality determined from one-ratio test. We also compared time of post-trauma admission with mortality and burned body surface area with mortality. RESULTS: mean R-Baux score was 75.2, which means an expected mortality of 5% among major burn patients. However, in this study, mortality in the group of children with large burned body surface area was of 60%, p=0.001, a rate far beyond that expected in literature. CONCLUSION: despite the innumerable variables, we consider the hypothesis of the pediatric trauma care infrastructure being inferior than the one needed in the state. This study suggests a greater incentive for public policies concerning pediatric trauma care, prepared referral center, well-established transfer agreements, and optimization of catastrophe plans, in order to reduce morbimortality of patients who survive the first hour after trauma.


Assuntos
Unidades de Queimados/estatística & dados numéricos , Queimaduras/mortalidade , Queimaduras/terapia , Vítimas de Crime/estatística & dados numéricos , Fatores Etários , Superfície Corporal , Brasil , Criança , Pré-Escolar , Feminino , Mortalidade Hospitalar , Humanos , Escala de Gravidade do Ferimento , Masculino , Valores de Referência , Estudos Retrospectivos , Análise de Sobrevida
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