Factors Affecting Mortality in Burn Patients: A Retrospective Study at a Lebanese University Medical Center

Burn injuries are a critical public health issue globally, causing significant morbidity and mortality. This study investigates factors influencing mortality in burn patients. It also examines the effectiveness of total body surface area (TBSA) as a predictor of mortality, suggesting a new threshold to improve patient management and outcome predictions. A retrospective study was conducted at Lebanese Hospital Geitaoui - UMC from 2017 to 2023. The study included 474 patients with second-degree and third-degree burns. Statistical analyses were performed to identify factors significantly associated with mortality, and to assess the predictive power of TBSA. Of the 474 patients, 395 (83.3%) survived while 79 (16.7%) succumbed to their injuries. Patients with TBSA between 81% and 90% had a survival rate of 0%. The logistic regression analysis indicated that for each 1% increase in TBSA, the odds of mortality increased by 6% (p<0.001). Inhalation injuries were present in 70.9% of non-survivors (p<0.001). Patients requiring mechanical ventilation had markedly higher mortality (84.8% vs 15.2%) (p<0.001). Multi-site infections were notably more common among non-survivors (32.9%) substantially increasing mortality risk (p=0.001). The ROC curve analysis confirmed TBSA's strong predictive value. The optimal cutoff point identified was 42.5% TBSA, above which the mortality risk increases significantly. The study highlights the significant impact of demographic factors, burn severity and medical interventions on the survival of burn patients. TBSA emerged as a robust predictor of mortality, underscoring the need for targeted interventions and specialized care for patients with extensive burns.