Long term mortality in critically ill burn survivors

Area of Science:

• Critical care medicine
• Burn surgery
• Trauma surgery

Background:

• Long-term survival risk factors for critically ill burn patients are not well understood.
• This study investigates long-term outcomes in burn survivors.
• A hypothesis posited favorable long-term outcomes for major burn survivors.

Purpose of the Study:

• To identify long-term survival risk factors in critically ill burn patients.
• To compare 5-year mortality rates between major burn survivors and those with less severe burns.
• To explore factors influencing long-term outcomes post-hospitalization.

Main Methods:

• An observational cohort study of 365 critically ill adult burn patients who survived hospitalization.
• Major burn defined as >20% total body surface area burned (TBSA).
• Five-year all-cause mortality assessed using multivariable logistic and Cox proportional hazard regression models, adjusting for key covariates.

Main Results:

• Major burn patients (>20% TBSA) had significantly lower 5-year post-discharge mortality (OR=0.29, P=0.014) and lower mortality following hospital admission (HR=0.34, P=0.009).
• The modified Baux score did not predict post-discharge mortality.
• Survivors of major burns were younger and had higher comorbidity, acute organ failure, inhalational injury, and sepsis upon ICU admission.

Conclusions:

• Critically ill patients with major burns who survive hospitalization exhibit decreased 5-year mortality compared to those with less severe burns.
• Burn unit survivors are typically younger with fewer comorbidities, suggesting higher physiological reserve.
• This physiological reserve may confer a survival advantage during recovery after major burn injury.