Hospital mortality and length of ICU stay in severely burned patients

Introduction

Survival and the length of ICU stay (LOS) of severely ill or injured patients are dependent on demographic (for example, age, gender) and organizational factors as well as pre-existing diseases and the degree of physiological abnormalities. Different scores allow one to predict hospital mortality of general ICU patients. Such scores (for example, APACHE II or SAPS II) are developed by multivariate statistical methods. Burned patients, however, have been excluded in the development of most scoring systems. We are interested in finding relevant risk factors concerning hospital mortality and LOS.

Methods

Patients with >10% burned surface area (BSA) admitted to the burn unit of the University Hospital Zurich between 1997 and 2006 were retrospectively analysed. Relevant epidemiologic and clinical parameters were included in a univariate analysis and subsequently in a multivariate analysis with either hospital mortality or LOS as endpoints.

Results

Six hundred and sixty-two burned patients were treated between 1997 and 2006. Four hundred and eighty-nine patients having a BSA > 10% were included. One hundred and forty-one (28.8%) died and the median LOS was 19 days in survivors. There were no changes in overall mortality, gender distribution, surgical treatment ore intensive care throughout the whole study period.

Conclusion

We could confirm age, burned surface area, male sex, inhalation injury, diabetes mellitus and psychiatric illness of any kind as important risk factors for mortality. Additionally, suicide attempts were included in the model but did not reach statistical significance. LOS in survivors was correlated with burned surface area, inhalation injury and the presence of suicide attempt.