Risk Factors for Sepsis and Pulmonary Embolism Mortality in Burn Patients by Using a Competing Risk Model: A Machine...

Severe burn injury remains a prevalent cause of morbidity and mortality over the last several decades. Various potential complications significantly contribute to mortality in burn patients. Sepsis and pulmonary embolism (PE) are among the leading causes of death following burn injury.

This retrospective study was conducted at a burn center in southwest Iran. In the current study, competing risk analysis was performed. Two events were considered death due to PE, which is the event of interest, and the competing event defined as death due to sepsis. Discharge was considered as a censor. Hazard ratios (HR) and standard errors (SE) were used to estimate the risk of death.

The study included 623 patients, with a total of 458 deaths (73.5%). Among them, 17 (2.7%) were due to PE, and 441 (70.8%) were attributed to sepsis-related mortality. Lower limb burns were the most frequent injury site among survivors (77.0%) and PE cases (82.3%). Flame burns were the most common etiology in all groups. The need for mechanical ventilation is also associated within increasing hazard of mortality in both events. Patients with burns in the lower limbs are more likely to die from PE (HR = 3.15) and sepsis (HR = 2.10). A higher RBC count was associated with a decreased risk of mortality from both PE (HR: 0.66) and sepsis (HR: 0.53). Similarly, hemoglobin levels had a modest protective effect against both causes of death.

These results highlight the complex relationship between burn characteristics, laboratory indicators, and demographic factors in determining mortality risk. Both clinical and laboratory parameters, as well as burn site and severity, play important roles in predicting outcomes in burn patients.