Burns : journal of the International Society for Burn Injuries
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To examine the characteristics and outcomes of myocardial infarction (MI) among burn patients. ⋯ Of 200,130 hospitalizations with burns, 1997 (1 %) developed acute MI. Burn patients with MI were older, more likely to be men, and had a higher prevalence of cardiovascular risk factors. Only burns affecting the trunk and respiratory tract, and those affecting > 20 % of body surface area (BSA), were associated with an increased risk of MI. All-cause in-hospital mortality was higher among patients with MI (18.7 % vs. 3 %, adjusted odds ratio (aOR) 4.59, 95 % confidence interval (CI) 3.66, 5.76). Cardiogenic shock, ventricular tachycardia, and stroke rates were higher among patients with MI. Revascularization was associated with lower in-hospital mortality (aOR 0.33, 95 % CI 0.17, 0.64) CONCLUSIONS: The incidence of MI in burn patients is low but is associated with high mortality and morbidity. Burns involving the trunk and respiratory tract, and those affecting > 20 % BSA, were associated with an increased risk of MI. Revascularization was associated with lower in-hospital mortality.
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To identify burn patients needing intensive rehabilitation based on discharge symptoms. ⋯ We identify distinct burn patient clusters based on discharge symptoms, with Cluster 3 exhibiting the highest post-discharge healthcare needs. BURN-OP (https://burn-op.streamlit.app/) identifies high-risk patients, offering a tool for prioritizing interventions and designing trials that mitigate risk of Cluster 3 membership.
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To share our 20-year experience in major burn management and the impact of a newly implemented burn protocol since 2015 at Tri-Service General Hospital (TSGH). ⋯ The new TSGH Burns Protocol revolutionized the care of major burns by introducing tailored, multidisciplinary burn management and improved patient outcomes.
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Burn injuries present a significant challenge globally, particularly in low- and middle-income countries (LMICs) where access to standard intravenous (IV) fluid resuscitation is often limited. In such austere settings, the feasibility of enteral resuscitation via oral rehydration solution (ORS) as an alternative to burn resuscitation is a critical consideration. We aimed to investigate the barriers and facilitators perceived by burn care providers in Nepal trained to use an enteral resuscitation protocol. ⋯ This study highlights the importance of stakeholder engagement, iterative refinement, and contextual adaptation in implementing an enteral resuscitation protocol for acute burn injuries. Findings offer insights into real-world applications and future clinical and research endeavors, informing the potential scalability and sustainability of enteral resuscitation protocols more broadly, to improve the care of patients with major burns in LMICs.
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Literature examining the impact of obesity on burn injury remains mixed. Previous examination of the National Burn Repository, now the BCQP, in obesity-related burn research is limited. The aim of this work was to provide an assessment of the BCQP dataset to examine the effect of obesity on burn-related outcomes. ⋯ The presence of obesity in this dataset was not found to be a predictor of mortality for any burn size, but was a predictor of overall LOS, ICU LOS, and total hospital costs. Including obesity-related variables in databases may improve analysis in obesity-related burn research.