Risk factors for mortality in the severely burned child

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Omar Naveda Romero
Andrea Fabiola Naveda Meléndez
Rafael José Meléndez Freitez

Abstract

Introduction: severe burns may involve all organs and tissues of the human body, leading to a series of pathophysiological processes and even death. Objective: To determine risk factors for mortality in major burns children. Methods: a retrospective cross-sectional study was conducted in the Hospital Universitario de Pediatría "Dr. Agustín Zubillaga (Barquisimeto, Lara State, Venezuela) between 2010 to 2019. Results: a total of 116 children with major burns were included in the analysis. The mortality rate was 27.6 %. The factors associated with mortality were total burned surface area more than 35 %, burn full-thickness, mechanisms: flame, inhalation injury, weight loss during hospitalization greater than 15 %, and five or more red blood cell transfusions (RBCT). Through binary logistic regression was identified as predictors for mortality in major burn children: burn full-thickness (OR=11.736; CI-95%: 1.138 – 121.074; p = 0.039) and weight loss during hospitalization greater than 15 % (OR=22,257; CI-95 %: 2.783 - 178.024; p = 0.003). A significant increase in the risk of mortality among burn children according to five or more RBCT (p = 0.049) was observed as per the Kaplan-Meier method. Conclusions: Burn full thickness and weight loss during hospitalization greater than 15 % were identified as independent variables related to mortality in major burn children.

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How to Cite
Naveda Romero, O., Naveda Meléndez, A. F., & Meléndez Freitez, R. J. (2020). Risk factors for mortality in the severely burned child. Pediatría, 53(3), 83–90. https://doi.org/10.14295/rp.v53i3.225
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Originals

References

Zheng Y, Lin G, Zhan R, Qian W, Yan T, Sun L, et al. Epidemiological analysis of 9,779 burn patients in China: An eight‑year retrospective study at a major burn center in southwest China. Exp Ther Med. 2019; 17: 2847-2854. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2018update_full.pdf.

https://doi.org/10.3892/etm.2019.7240.

Osler T, Glance L, Hosmer D. Simplified estimates of the probability of death after burn injuries: Extending and updating the baux score. J Trauma. 2010; 68: 690-7.

Tobiasen J, Hiebert JM, Edlich RF. The abbreviated burn severity index. Ann Emerg Med. 1982; 11: 260-2.

Demirdjian G, Yunis A. Validación prospectiva del score D.E.M.I para predecir pronóstico en niños quemados. Medicina Infantil. 1995; 3: 181 – 185. Disponible en: https://www.medicinainfantil.org.ar/images/stories/volumen/1995/ii_3_181.pdf

Fernández Y, Melé M. Quemaduras. Protocolos diagnósticos y terapéuticos en urgencias de pediatría. Sociedad Española de Urgencias de Pediatría (SEUP), 3ª Edición. 2019. Disponible en: https://seup.org/pdf_public/pub/protocolos/21_Quemaduras.pdf

Greenhalgh DG, Saffle JR, Holmes JH. American Burn Association. Consensus conference to define sepsis and infections in burns. J Burn Care Res. 2007; 28: 776–90. https://www.cdc.gov/infectioncontrol/guidelines/bsi/index.html

Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int. 2012; Suppl 2:1-138. Disponible en: https://www.karger.com/Article/Fulltext/339789

Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care associated infection and criteria for specific types of infection in the acute care setting. Am J Infect Control. 2008; 36: 309–32.

Fung M, Grossman B, Hillyer Ch, Westhoff C. AABB Technical Manual 2014. Disponible en: https://archive.org/details/ AABBTechnicalManual18thEd2014

Kazemzadeh J, Vaghardoost R, Dahmardehei M, Rabiepoor S, Farzan R, Asghar Kheiri A, et al. Retrospective Epidemiological Study of Burn Injuries in 1717 Pediatric Patients: 10 Years Analysis of Hospital Data in Iran. Iran J Public Health. 2018; 47(4): 584-590. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29900144/

Dewi W, Christie CD, Wardhana A, Fadhilah R, Pardede SO. Pediatric Logistic Organ Dysfunction-2 (Pelod-2) score as a model for predicting mortality in pediatric burn injury. Ann Burns Fire Disasters. 2019; 32(2): 135-142. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31528154/

Dhopte A, Bamal R, Tiwari VK. A prospective analysis of risk factors for pediatric burn mortality at a tertiary burn center in North India. Burs Trauma. 2017; 5:30 Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606015/ pdf/41038_2017_Article_95.pdf

Tsurumi A, Que YA, Yan S, Tompkins RG, Rahme LG, Ryan CM. Do standard burn mortality formulae work on a population of severely burned children and adults?. Burns. 2015; 41(5):935–45.

Barcellos LG, Silva APPD, Piva JP, Rech L, Brondani TG. Characteristics and outcome of burned children admitted to a pediatric intensive care unit. Rev Bras Ter Intensiva. 2018; 30(3): 333-337.

Foncerrada G, Culnan DM, Capek KD, González-Trejo S,Cambiaso-Daniel J, Woodson LC, et al. Inhalation Injury in the Burned Patient. Ann Plast Surg. 2018; 80(3): S98-S105. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825291/

Moreira E, Burghi G, Manzanares W. Metabolismo y terapia nutricional en el paciente quemado crítico: una revisión actualizada. Med Intensiva. 2018; 42 (5): 306 – 316.

Conrad P, Liberio J, Aleem R, Halerz M, Mosier M, Sanford A, et al. Improving nutritional support of burn service patients by increasing the number of days when 100% of prescribed formula is given. J Burn Care Res. 2017; 38 (6): 379 – 389.

Palmieri T. Children are not little adults: blood transfusion in children with burn injury. Burs & Trauma. 2017; 5:24 DOI 10.1186/s41038-017-0090-z

Remy KE, Hall MW, Cholette J, Jufermans NP, Nicol K, Doctor A, et al. Mechanisms of red blood cell transfusion-related immunomodulation. Transfusion. 2018; 58(3): 804 – 815.

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