scholarly journals BURN PATIENTS;

2013 ◽  
Vol 20 (06) ◽  
pp. 1042-1047
Author(s):  
FIRDOUS KHAN ◽  
ASIF SHAH ◽  
ABDUL AZIZ JANAN
Keyword(s):  
Hospital Stay ◽  
Plastic Surgery ◽  
Teaching Hospital ◽  
Burn Injury ◽  
Demographic Data ◽  
Total Body Surface Area ◽  
Length Of Hospital Stay ◽  
Descriptive Study ◽  
Burn Patients ◽  
Key Factor

Aim: To determine major risk factors of mortality and causes of death in patients presented with burn injury. Study design:Prospective Descriptive Study. Setting and duration: Department of Burns and Plastic Surgery, Khyber Teaching Hospital, Peshawar,Pakistan from April 2008 and June 2012. Methodology: A prospective descriptive study was performed among the patients whoadmitted to the Department of Burns and Plastic Surgery, Khyber Teaching Hospital, Peshawar, Pakistan between April 2008 and June2012. All relative information was collected through a detailed proforma and patient’s treatment files. Patients of any age, any degree ofburns and burns exceeding 10% TBSA were included. Patients presenting after more than one week post burn or patients referred fromother hospitals were excluded. Within this period, demographic data, treatment, and outcomes of treatment were reviewed and analyzed.Survivors and non-survivors among burn patients were compared to define the predictive factors of mortality. Results: Between April2008 and June 2012, 1850 patients were admitted with burn injuries. There were 1150 male patients (62%) and 700 female patients(38%). Mean age was 36 years with range of 1-70 years. Inhalation injuries were present in 45 patients (2.40%). Causes were flameburns (65.0%), electrical burns (15%), scalds (13%) and chemical burns (7.0%). The total body surface area (TBSA) burn ranged from10- 100%, with a mean of 38% TBSA burn. Mean length of hospital stay was 12 days (ranging from 24 hours to 170 days). Mortality ratewas 11.2%. Higher age, larger burn area, wound infection, longer hospital stay and the presence of multi-system organ failuresignificantly predicted increased mortality. Conclusions: Prevention is a key factor in reducing the morbidity and mor tality associatedwith burn injury. A campaign to educate people that burns can be prevented will be important in our community. The prevention of multiorganfailure and septicemia are likely to be more effective than their treatment.

scholarly journals Burn Patients at Western Regional Hospital of Nepal: An Epidemiological Study

2020 ◽  
Vol 3 (1) ◽  
pp. 225-228
Author(s):  
Amar Gurung ◽  
Dilip Baral ◽  
Narendra Vikram Gurung ◽  
Arjun Acharya ◽  
Suresh Raj Poudel ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Epidemiological Study ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Total Duration ◽  
Morbidity And Mortality ◽  
High Rate ◽  
Burn Patients ◽  
Prolonged Hospital ◽  
Epidemiological Characteristics

Background: Burn injury is one of the major causes of morbidity and mortality in our country. Study of epidemiological characteristics of burn injury helps in planning of the prevention and upgradation of its treatment facility. Material and Methods: This is a hospital based retrospective epidemiological study of the burn patients admitted in our center from September 2018 to April 2019. Results: In total 52 patients were included in this study. There was a slight preponderance of female patients over male patients. Mean age of the patients was 34.77± 29.16 years. Eighty percentage of burn injury occurred inside house. Majority of burn cases were scald burn followed by flame burn. Percentage total body surface area involved in burn had a mean of 14.183 ± 8.224. Lower extremity was the most commonly involved area. Total duration of hospital stay was 18.21 ± 13.656 days. Out of total patients only four patients needed admission in Intensive Care Unit (ICU). Regarding outcome, 88.5% patients survived while 9.6% patients died and 1.9% patient went on discharge on request. Conclusion: Burn injury is a preventable condition with high rate of morbidity and mortality. Burn patients have prolonged hospital stay as recovery is slow. Awareness programs for prevention of burn injury are needed to decrease the incidence of the burn injury.

scholarly journals Burns infection profile of Singapore: prevalence of multidrug-resistant Acinetobacter baumannii and the role of blood cultures

2016 ◽  
Vol 4 ◽  
pp. 1-9 ◽  
Author(s):  
Christopher Tam Song ◽  
Jolie Hwee ◽  
Colin Song ◽  
Bien Keem Tan ◽  
Si Jack Chong
Keyword(s):  
Hospital Stay ◽  
Acinetobacter Baumannii ◽  
Total Body Surface Area ◽  
Length Of Hospital Stay ◽  
Multidrug Resistant ◽  
Blood Cultures ◽  
Burn Patients ◽  
Perioperative Antibiotics ◽  
Infection Profile

Abstract Background With various changes implemented such as perioperative antibiotics for tangential excision, this retrospective study reviews the infection profile of burn patients at Singapore’s only centralized burns unit. Worldwide, the appearance of multidrug-resistant (MDR) strains of Acinetobacter baumannii (A. baumannii) continues to worsen patient outcomes. This study also surveys the role of blood cultures in burns at our unit. Methods Four hundred fifty-two burn patients admitted to the unit between 2011 and 2013, and with cultures performed, were included in the study. The yields of various cultures were evaluated and 2684 samples were amassed, of which 984 (36.7 %) were positive. Patient variables for predictors of MDR A. baumannii infection acquisition and bacteremia were evaluated through multivariate analyses. Results Pseuodomonas aeruginosa (P. aeruginosa) (67 patients) was the most common organism in those with total body surface area (TBSA) burn <20 % while MDR A. baumannii (39 patients) was most prevalent in those with TBSA burn ≥20 %. We found a yield of 1.1 % positive blood cultures for TBSA burn <20 % and a yield of 18.6 % positive cultures in TBSA burn ≥20 %. The median time between surgery and bacteremia was 6.5 days (range -18 to 68 days, interquartile range 4.5); 2.9 and 8.8 % of bacteremic episodes occurred within 24 and 48 h, respectively. This is a decrease from a predeceasing study (45.3 % for 24 h and 60 % for 48 h). Multivariate analysis revealed that length of hospital stay and TBSA burn ≥20 % were predictors of MDR A. baumannii infection and positive blood cultures. Conclusions MDR A. baumannii infection burdens patient management, especially in those with TBSA burn ≥20 % and longer hospital stay. Prophylactic antibiotics may reduce perioperative bacteremia, but their role in MDR infections needs to be evaluated. The role of blood cultures in TBSA burn <20 % needs reconsideration.

scholarly journals Burn Injury Induces Proinflammatory Plasma Extracellular Vesicles That Associate with Length of Hospital Stay in Women: CRP and SAA1 as Potential Prognostic Indicators

2021 ◽  
Vol 22 (18) ◽  
pp. 10083
Author(s):  
Robert Maile ◽  
Micah L. Willis ◽  
Laura E. Herring ◽  
Alex Prevatte ◽  
Cressida Mahung ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Extracellular Vesicles ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Length Of Hospital Stay ◽  
Immune Dysfunction ◽  
Prognostic Indicators ◽  
Post Injury ◽  
Splenic Macrophages ◽  
Proinflammatory Responses

Severe burn injury is a devastating form of trauma that results in persistent immune dysfunction with associated morbidity and mortality. The underlying drivers of this immune dysfunction remain elusive, and there are no prognostic markers to identify at-risk patients. Extracellular vesicles (EVs) are emerging as drivers of immune dysfunction as well as biomarkers. We investigated if EVs after burn injury promote macrophage activation and assessed if EV contents can predict length of hospital stay. EVs isolated early from mice that received a 20% total body surface area (TBSA) burn promoted proinflammatory responses in cultured splenic macrophages. Unbiased LC-MS/MS proteomic analysis of early EVs (<72 h post-injury) from mice and humans showed some similarities including enrichment of acute phase response proteins such as CRP and SAA1. Semi-unbiased assessment of early human burn patient EVs found alterations consistent with increased proinflammatory signaling and loss of inhibition of CRP expression. In a sample of 50 patients with large burn injury, EV SAA1 and CRP were correlated with TBSA injury in both sexes and were correlated with length of hospital stay in women. These findings suggest that EVs are drivers of immune responses after burn injury and their content may predict hospital course.

scholarly journals Elderly And Burn Injuries: A Ten-Year Analysis of 612 Patients

2021 ◽  
Author(s):  
Zahra Haghani Dogahe ◽  
Reza Zarei ◽  
Shahin Hallaj ◽  
Mohammadreza Mobayen
Keyword(s):  
Hospital Stay ◽  
Geriatric Medicine ◽  
Total Body Surface Area ◽  
Length Of Hospital Stay ◽  
Prevention Programs ◽  
The Elderly ◽  
Burn Injuries ◽  
Anatomical Site ◽  
Burn Patients ◽  
The Mean

Abstract Background: With all the progress made in geriatric medicine, we expect to have a growing population of elderly soon. With burn injuries, as one of the most common unpredictable injuries to the elderly, it is essential to clarify the epidemiological pattern and factors related to worse outcomes in geriatric burn patients. We aimed to investigate burn characteristics in the elderly in Guilan province, IRAN, in ten years.Methods: This study conducted a retrospective analysis of burn patients aging 60yrs and over in Velayat Burn Center between 2010 and 2020. The data collected from the hospital information system included age, sex, marital state, occupation, residency, season and month of the incident, place of incident, total body surface area (TBSA), burn degree, cause of the burn, anatomical site of the injury, pre-injury morbidities, surgical managements, length of hospital stay and mortality.Results: Among 612 patients, the mean age was 72.20±8.94 years. The female to male ratio was 1.14:1 with a total of 53.3% female burn patients. 94.90% of patients lived with family members. 59.3% lived in urban areas. Most of the burn injuries happened during winter and summer. 82.5% happened indoors. The mean was 19.70±22.13%. The most common causes were flames (50.0%) and scalds (44.3%). The mean length of hospital stay (LOS) was 6.14±6.27 days. The overall mortality rate was 15%.Conclusion: We concluded that most burn injuries among the geriatric population happen indoors, during the first hours of the day, and on the first day of the week, making it essential to establish special prevention programs suiting these situations. On the other hand, with the increased life expectancy and the unpredictable nature of burn injuries, it is essential to identify risk factors and establish prevention programs for the elderly.

scholarly journals Epidemiology of foot burns in a Dutch burn centre

2015 ◽  
Vol 3 ◽  
pp. 1-6 ◽  
Author(s):  
Tülay Kılıç ◽  
Pieta Krijnen ◽  
Wim E Tuinebreijer ◽  
Roelf S Breederveld
Keyword(s):  
Hospital Stay ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Length Of Hospital Stay ◽  
Bed Rest ◽  
Late Complications ◽  
Adverse Outcomes ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Almost All

Abstract Background Although the feet involve a small percentage of the total body surface area, they can have major effects in daily life, caused by prolonged bed rest, hospitalization and high risk of both early and late complications. The aim of this study was to define the aetiology, treatment and outcomes of foot burns, with special interest in paediatric patients, patients with diabetic disease and burns acquired at the workplace. Methods This is a retrospective cohort study of 82 patients who were admitted to one of the three burn centres in the Netherlands during the period 2004 to 2013. The patients had a median age of 43.5 years (range 0.01–85.9), and included 14 children and 8 diabetics. Data were collected from the hospital records. Results Scalding was the most common cause of the injury. Almost all patients required surgical management. It is notable that most of hospitalized patients (82 %) were not admitted on the day of injury. Children had a significantly shorter length of stay compared to adults (p = 0.01). The eight patients with diabetes had a significantly longer length of hospital stay, more complications and more often residual defects compared to the non-diabetic patients. In 13 patients, the injury took place at work. Half of these burns were caused by scalding, and foot burns caused by chemicals at work were rare (two patients). Conclusions Although the incidence of foot burns is low, there is a significant morbidity due to complications and long hospital stay. The following three points are suggested. Immediate referral to a burn centre is essential. It is important to educate diabetic patients on the risk of complications and adverse outcomes after burn injury. Preventative measures at the workplace are worth considering.

Effect of Chewing Gum on Bowel Motility in Women Undergoing Post-Operative Cesarean Section

2018 ◽  
Vol 3 (06) ◽  
Author(s):  
Dr.Randa Mohammed AboBaker
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Chewing Gum ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Bowel Motility ◽  
Gum Chewing ◽  
Significant Difference

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay.  Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.

11 Vitamin D Deficiency on Admission and the Association with Length of Stay in Patients with Thermal Injury: A Multi-center Analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S13-S14
Author(s):  
Sarah Zavala ◽  
Kate Pape ◽  
Todd A Walroth ◽  
Melissa A Reger ◽  
Katelyn Garner ◽  
...  
Keyword(s):  
Vitamin D ◽  
Length Of Stay ◽  
Vitamin D Deficiency ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Inhalation Injury ◽  
Hospital Length Of Stay ◽  
Burn Patients ◽  
Comfort Care ◽  
The Impact

Abstract Introduction In burn patients, vitamin D deficiency has been associated with increased incidence of sepsis. The objective of this study was to assess the impact of vitamin D deficiency in adult burn patients on hospital length of stay (LOS). Methods This was a multi-center retrospective study of adult patients at 7 burn centers admitted between January 1, 2016 and July 25, 2019 who had a 25-hydroxyvitamin D (25OHD) concentration drawn within the first 7 days of injury. Patients were excluded if admitted for a non-burn injury, total body surface area (TBSA) burn less than 5%, pregnant, incarcerated, or made comfort care or expired within 48 hours of admission. The primary endpoint was to compare hospital LOS between burn patients with vitamin D deficiency (defined as 25OHD &lt; 20 ng/mL) and sufficiency (25OHD ≥ 20 ng/mL). Secondary endpoints include in-hospital mortality, ventilator-free days of the first 28, renal replacement therapy (RRT), length of ICU stay, and days requiring vasopressors. Additional data collected included demographics, Charlson Comorbidity Index, injury characteristics, form of vitamin D received (ergocalciferol or cholecalciferol) and dosing during admission, timing of vitamin D initiation, and form of nutrition provided. Dichotomous variables were compared via Chi-square test. Continuous data were compared via student t-test or Mann-Whitney U test. Univariable linear regression was utilized to identify variables associated with LOS (p &lt; 0.05) to analyze further. Cox Proportional Hazard Model was utilized to analyze association with LOS, while censoring for death, and controlling for TBSA, age, presence of inhalation injury, and potential for a center effect. Results Of 1,147 patients screened, 412 were included. Fifty-seven percent were vitamin D deficient. Patients with vitamin D deficiency had longer LOS (18.0 vs 12.0 days, p &lt; 0.001), acute kidney injury (AKI) requiring RRT (7.3 vs 1.7%, p = 0.009), more days requiring vasopressors (mean 1.24 vs 0.58 days, p = 0.008), and fewer ventilator free days of the first 28 days (mean 22.9 vs 25.1, p &lt; 0.001). Univariable analysis identified burn center, AKI, TBSA, inhalation injury, admission concentration, days until concentration drawn, days until initiating supplementation, and dose as significantly associated with LOS. After controlling for center, TBSA, age, and inhalation injury, the best fit model included only deficiency and days until vitamin D initiation. Conclusions Patients with thermal injuries and vitamin D deficiency on admission have increased length of stay and worsened clinical outcomes as compared to patients with sufficient vitamin D concentrations.

scholarly journals Surviving Burn Injury: Drivers of Length of Hospital Stay

2021 ◽  
Vol 18 (2) ◽  
pp. 761
Author(s):  
Chimdimma Noelyn Onah ◽  
Richard Allmendinger ◽  
Julia Handl ◽  
Ken W. Dunn
Keyword(s):  
Mental Status ◽  
Burn Injury ◽  
Length Of Hospital Stay ◽  
Care Plan ◽  
Burn Patients ◽  
Emotional Needs ◽  
Effective Care ◽  
Significant Difference ◽  
Unitary Model ◽  
Hospital Resources

With a reduction in the mortality rate of burn patients, length of stay (LOS) has been increasingly adopted as an outcome measure. Some studies have attempted to identify factors that explain a burn patient’s LOS. However, few have investigated the association between LOS and a patient’s mental and socioeconomic status. There is anecdotal evidence for links between these factors; uncovering these will aid in better addressing the specific physical and emotional needs of burn patients and facilitate the planning of scarce hospital resources. Here, we employ machine learning (clustering) and statistical models (regression) to investigate whether segmentation by socioeconomic/mental status can improve the performance and interpretability of an upstream predictive model, relative to a unitary model. Although we found no significant difference in the unitary model’s performance and the segment-specific models, the interpretation of the segment-specific models reveals a reduced impact of burn severity in LOS prediction with increasing adverse socioeconomic and mental status. Furthermore, the socioeconomic segments’ models highlight an increased influence of living circumstances and source of injury on LOS. These findings suggest that in addition to ensuring that patients’ physical needs are met, management of their mental status is crucial for delivering an effective care plan.

scholarly journals Management of post-operative discitis following discectomy in a tertiary-level hospital

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902098821
Author(s):  
Md Kamrul Ahsan ◽  
Md Sariful Hasan ◽  
Md Shahidul Islam Khan ◽  
Najmus Sakeb
Keyword(s):  
Hospital Stay ◽  
Antibiotic Treatment ◽  
Demographic Data ◽  
Japanese Orthopaedic Association ◽  
Clinical Signs ◽  
Length Of Hospital Stay ◽  
Tertiary Level ◽  
Disc Space ◽  
The Difference ◽  
Level Hospital

Purpose: To perform retrospective analysis of 75 post-operative disc space infections after open lumbar discectomy (OLD) and to assess the outcome of their medical and surgical management in a tertiary-level hospital. Methods: Records of 50 men and 25 women aged 26–65 (mean, 42.53) years who underwent treatment for post-operative discitis (POD) after single level OLD at L3–4 (n = 8), L4–5 (n = 42), L5–S1 (n = 25) level. The POD was diagnosed according to specific clinical signs, laboratory and radiographic investigations and all of them received initial intravenous antibiotics (IVA) for at least 4–6 weeks followed by oral ones. Successful responders (n = 55) were considered in Group-C and remainder [Group-S (n = 20)] were operated at least after 4 weeks of failure. Demographic data, clinical variables, hospital stay, duration of antibiotic treatment and post-treatment complications were collected from the hospital record and assessment before and after treatment were done by using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score. Comprehensive outcome was evaluated by modified criteria of Kirkaldy-Willis. Results: The mean follows up was 36.38 months. Significant improvement of mean VAS and JOA score was achieved in both conservative (76.36% satisfactory) and operative (90% satisfactory) groups although the difference was statistically insignificant. Conclusion: Although insignificant, early surgical intervention provided better results (e.g. functional outcomes, length of hospital stay and duration of antibiotic treatment therapy) than conventional conservative treatment in post-operative discitis.

Sign in / Sign up

Export Citation Format

Share Document