DOI: http://dx.doi.org/10.18203/2349-2902.isj20204122

Initial assessment of mortality rates of burn patients in a tertiary care hospital by total body surface area, depth and facial burns, and its correlation with serial total leucocyte count

Kavitha Jayanthi Balachandran, Manoj Kumar Nirmalanandan

Abstract


Background: The pattern of burns in victims varies with the manner of infliction of burns. Age plays an important role in deciding the mortality and morbidity of burn victims. Other factors that decide the prognosis of burn victims are the total body surface area (TBSA), Depth of burns, and inhalational injury as evidenced by facial burns. Assessment of these epidemiological factors and inhalational injury can be done as a part of the initial evaluation. Such an assessment aid in resuscitation including emergent airway and decision making regarding the need for skin grafts or escharotomy. Serial measurement of total leucocyte count also helps in identifying the onset of infection and progress to septicaemia and increased mortality rates.

Methods: As a part of the initial evaluation, we attempt to study the relation between TBSA, Depth of burns, facial burns, and total WBC count with mortality. A background of septicaemia was also noticed in the majority of patients.

Results: For analysis, patients were divided into two groups- Survivors and Non-survivors. A fall in total WBC count coincided with the onset of sepsis and mortality. The other three factors also had a direct correlation with mortality rates.

Conclusions: A scoring system constituting all the factors is essential as an initial diagnostic step and it will help in deciding early intubation, escharotomy, and aggressive fluid resuscitation.


Keywords


Burns, Depth of burns, Facial burns, Inhalational injury, Total body surface area

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References


Honnegowda TM, Kumar P, Udupa P, Rao P. Epidemiological study of burn patients hospitalized at a burns centre, Manipal. Int Wound J 2019;16(1),79-83.

Burns- Clinical Key. Available at: https://www.clinicalkey.com/#!/content/book/3-s2.0-B9780323299879000199?scrollTo=%23refInSitubib27. Accessed on 15 May 2020.

Burn Treatment- Clinical Key. Available at: https://www.clinicalkey.com/#!/content/book/3-s2.0-B9780323476331001897?scrollTo=%23hl0000223 Accessed 14 May 2020.

Airway Management in Burn Patients- Clinical Key. Available at: https://www.clinicalkey.com/# !/content/book/3-s2.0-9780323428811000353?scroll To=%23hl0000254. Accessed 14 May 2020.

Burn Care Procedures- Clinical Key. URL https://www.clinicalkey.com/#!/content/book/3-s2.0-9780323354783000385?scrollTo=%23hl0001327 Accessed on 14 May 2020.

Halgas B, Bay C, Foster K. A comparison of injury scoring systems in predicting burn mortality. Ann Burns Fire Disasters. 2018;31(2):89-93.

Giretzlehner M, Dirnberger J, Owen R, Haller HL, Lumenta, DB, Kamolz, LP. The determination of total burn surface area: How much difference? Burns. 2013;39:1107-13.

Initial management of a major burn: II-assessment and resuscitation. Available at: https://reference. medscape.com/medline/abstract/15242917. Accessed 15 May 2020.

Bittner EA, Shank E, Woodson L, Martyn JAJ. Acute and Perioperative Care of the Burn-Injured Patient. Anesthesiol. 2015;122:448-64.

Sen S, Hsei L, Tran N, Romanowski K, Palmieri T, Greenhalgh D et al. Early clinical complete blood count changes in severe burn injuries. Burns. 2019;45(1):97-102.

Wasiak J, Cleland H. Burns: dressings. BMJ Clin Evid. 2015;14;2015:1903.

Pham C, Collier Z, Gillenwater J. Changing the Way We Think About Burn Size Estimation. J Burn Care Res. 2019;40(1):1-11.

Vivó C, Galeiras R, del Caz MDP. Initial evaluation and management of the critical burn patient. Med Intensiva. 2016;40(1):49-59.