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Author Spotlight: A Multi-Depth Porcine Model for Comprehensive Study of Burn Injuries and Healing Processes
Published on: February 23, 2024
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The lethal triad in patients with severe burns
Elisha Purcell1, Samara Rosenblum2, Biswadev Mitra3
1School of Public Health and Preventive Medicine, Monash University, Australia.
Burns : Journal of the International Society for Burn Injuries
|December 12, 2025
Summary
The lethal triad of trauma (acidemia, coagulopathy, hypothermia) was present in 5.7% of severe burn patients. All patients with the triad died, highlighting the need for early recognition and management in burn care.
Area of Science:
- Trauma care
- Burn injury management
- Critical care medicine
Background:
- The lethal triad of trauma (acidemia, coagulopathy, hypothermia) significantly increases morbidity and mortality in trauma patients.
- Severe burn injuries (>20% total body surface area) place patients at risk for developing the lethal triad.
- Limited evidence exists on the impact of the lethal triad specifically in severe burn patient cohorts.
Purpose of the Study:
- To determine the prevalence of the lethal triad in severe burn patients upon hospital admission.
- To identify factors potentially associated with the presence of the lethal triad in this patient group.
Main Methods:
- Adult patients (>18 years) with severe burns (>20% TBSA) admitted to a Victorian Adult Burns Service (VABS) tertiary hospital were studied.
- Data was collected retrospectively from January 1, 2019, to December 31, 2023.
- Prevalence of acidemia, coagulopathy, and hypothermia was assessed on arrival.
Main Results:
- The lethal triad was present in 5.7% (6/106) of severe burn patients on arrival.
- Acidemia (50.0%) and hypothermia (37.9%) were more common than coagulopathy (14.4%).
- Patients with the lethal triad had a significantly higher mortality rate (100%) compared to those without (27.0%), with an odds ratio of 21.0.
Conclusions:
- A small but significant proportion of severe burn patients present with the lethal triad.
- Acidemia and hypothermia are key components of the triad in this population.
- Early recognition, prevention, and management of the lethal triad are crucial for improving outcomes in severe burn patients.
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