Historical evolution of the mortality in burned patient at the Centro Nacional de Quemados (National Burns Center) between 1995 and 2017

Abstract

Introduction:

burned patients mortality has decreased because of a better understanding of initial shock pathophysiology, early surgical interventions, antibiotic therapy optimization and appropriate nutritional support. Mortality reduction has also been related to the creation of specialized burn centers. There are no recent reports of burn injury patients in our country.

Objective:

to describe characteristics and evolution of patients assisted at the national burned center (Centro Nacional de Quemados, Uruguay).

Methods:

transversal, observational, descriptive study. All patients admitted in the center with diagnosis of skin burns or inhalation injury, from the center’s opening in 1995 through December 31, 2017.

Results:

during the study period 3,050-burned patients were admitted, 25% of which had a total body surface area burnt of at least 20%. There was a predominance of male sex (62%) and young patients (more than 60% had less than 50 years old). The most frequent responsible agent was direct fire (71%), followed by hot liquids (9%) and electricity (5%). Mechanical ventilation was needed in 43% of the patients, and mean length of stay in the center was 17 days. Overall mortality rate was 19.7%, accordingly to that predicted by specific severity scores. In the sub-group of more severe patients, mortality has progressively decreased since the center opening.

Conclusions:

our center assists young patients with burn injuries mostly caused by direct fire. Overall mortality is in line with the expected according to severity scores, having decreased progressively since the center inauguration.