[Chronic Critical Illness in Burns: Incidence and Risk Factors]

Chronic critical illness (CCI) characterizes patients admitted to intensive care who, following an acute illness, remain dependent on care. Its incidence varies from 5 to 55% depending on the population studied. This retrospective, case-control study, conducted over a year in the Burn ICU of Tunis, included all patients aged over 16 years, burned, and hospitalized for more than 8 days. CCI was defined according to the criteria of the Research Triangle Institute (a hospital stay of more than 8 days and at least one of the following: sepsis, invasive mechanical ventilation for more than 96 hours, severe injury, traumatic brain injury or stroke, and tracheostomy). Among the 272 adult burn patients, 103 were included, with 85 developing CCI, representing an incidence of 31.2%. The eligible criteria identified were sepsis in 42.4% of cases (n=36) and invasive mechanical ventilation in 38.8% of cases (n=33). The average age was 41.5±16.9 years with a male predominance (n=53; 62.4%). The average TBSA was 29±16%. The risk factors for CCI in multivariate analysis were: TBSA >21.5%, the need for transfusion, the occurrence of anemia, thrombocytopenia, hypophosphatemia, acute renal failure, and metabolic acidosis. The median hospital stay was 12 days [8-128]. The mortality rate was 55.3%.