Cause of death and correlation with autopsy findings in burns patients

P. Krishnan, Q. Frew, A. Green, R. Martin, Peter Dziewulski

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objective: Global mortality from burns is decreasing however there is a relative paucity of mortality data in the literature from burns units in the United Kingdom. We present an analysis of burns deaths and correlation with coroners' autopsy findings from a large regional burns unit. Design: Retrospective medical note review of patients who died over a 7 year period (January 2005 to April 2011) was undertaken. Patient demographics were recorded in addition to: burn size, depth, length of stay, presence of inhalational injury, organs failing and diagnosis of sepsis. In order to evaluate the accuracy of our pre-mortem clinical diagnosis, we compared post-mortem cause of death with clinical cause of death. Results: There were 92 deaths out of 4745 admissions for acute burn (crude mortality 1.9%). 37 patients were immediately given comfort care and excluded from analysis. Average age was 52.9 years ± 19.4, average percentage burn 43.7% ± 26.8, and length of stay 26.4 ± 45 days. 80% of deaths were attributable to flame burn (44/55), and 51% (28/55) suffered inhalational injury. Multi-organ failure was the primary cause of death (39/55), with sepsis being the primary trigger (20/39, 51%). Pseudomonas was the most common organism isolated in septic patients. There were significant difficulties in obtaining post-mortem reports and an obvious lack of correlation between coroners' reports and clinical cause of death. Conclusions: The principal cause of mortality in our unit was multi-organ failure due to sepsis, which concurs with current literature. Autopsy has previously been shown to be a useful retrospective diagnostic tool, however we challenge its reliability as a result of our study.

Original languageEnglish (US)
Pages (from-to)583-588
Number of pages6
JournalBurns
Volume39
Issue number4
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

Fingerprint

Burns
Cause of Death
Autopsy
Burn Units
Sepsis
Coroners and Medical Examiners
Mortality
Length of Stay
Wounds and Injuries
Pseudomonas
Demography

Keywords

  • Burns
  • Coroner
  • Mortality
  • Multi-organ failure
  • Sepsis

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Cause of death and correlation with autopsy findings in burns patients. / Krishnan, P.; Frew, Q.; Green, A.; Martin, R.; Dziewulski, Peter.

In: Burns, Vol. 39, No. 4, 01.01.2013, p. 583-588.

Research output: Contribution to journalArticle

Krishnan, P. ; Frew, Q. ; Green, A. ; Martin, R. ; Dziewulski, Peter. / Cause of death and correlation with autopsy findings in burns patients. In: Burns. 2013 ; Vol. 39, No. 4. pp. 583-588.
@article{fe0b10ce404849d3a0b52ce39260c766,
title = "Cause of death and correlation with autopsy findings in burns patients",
abstract = "Objective: Global mortality from burns is decreasing however there is a relative paucity of mortality data in the literature from burns units in the United Kingdom. We present an analysis of burns deaths and correlation with coroners' autopsy findings from a large regional burns unit. Design: Retrospective medical note review of patients who died over a 7 year period (January 2005 to April 2011) was undertaken. Patient demographics were recorded in addition to: burn size, depth, length of stay, presence of inhalational injury, organs failing and diagnosis of sepsis. In order to evaluate the accuracy of our pre-mortem clinical diagnosis, we compared post-mortem cause of death with clinical cause of death. Results: There were 92 deaths out of 4745 admissions for acute burn (crude mortality 1.9{\%}). 37 patients were immediately given comfort care and excluded from analysis. Average age was 52.9 years ± 19.4, average percentage burn 43.7{\%} ± 26.8, and length of stay 26.4 ± 45 days. 80{\%} of deaths were attributable to flame burn (44/55), and 51{\%} (28/55) suffered inhalational injury. Multi-organ failure was the primary cause of death (39/55), with sepsis being the primary trigger (20/39, 51{\%}). Pseudomonas was the most common organism isolated in septic patients. There were significant difficulties in obtaining post-mortem reports and an obvious lack of correlation between coroners' reports and clinical cause of death. Conclusions: The principal cause of mortality in our unit was multi-organ failure due to sepsis, which concurs with current literature. Autopsy has previously been shown to be a useful retrospective diagnostic tool, however we challenge its reliability as a result of our study.",
keywords = "Burns, Coroner, Mortality, Multi-organ failure, Sepsis",
author = "P. Krishnan and Q. Frew and A. Green and R. Martin and Peter Dziewulski",
year = "2013",
month = "1",
day = "1",
doi = "10.1016/j.burns.2012.09.017",
language = "English (US)",
volume = "39",
pages = "583--588",
journal = "Burns",
issn = "0305-4179",
publisher = "Elsevier Limited",
number = "4",

}

TY - JOUR

T1 - Cause of death and correlation with autopsy findings in burns patients

AU - Krishnan, P.

AU - Frew, Q.

AU - Green, A.

AU - Martin, R.

AU - Dziewulski, Peter

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Objective: Global mortality from burns is decreasing however there is a relative paucity of mortality data in the literature from burns units in the United Kingdom. We present an analysis of burns deaths and correlation with coroners' autopsy findings from a large regional burns unit. Design: Retrospective medical note review of patients who died over a 7 year period (January 2005 to April 2011) was undertaken. Patient demographics were recorded in addition to: burn size, depth, length of stay, presence of inhalational injury, organs failing and diagnosis of sepsis. In order to evaluate the accuracy of our pre-mortem clinical diagnosis, we compared post-mortem cause of death with clinical cause of death. Results: There were 92 deaths out of 4745 admissions for acute burn (crude mortality 1.9%). 37 patients were immediately given comfort care and excluded from analysis. Average age was 52.9 years ± 19.4, average percentage burn 43.7% ± 26.8, and length of stay 26.4 ± 45 days. 80% of deaths were attributable to flame burn (44/55), and 51% (28/55) suffered inhalational injury. Multi-organ failure was the primary cause of death (39/55), with sepsis being the primary trigger (20/39, 51%). Pseudomonas was the most common organism isolated in septic patients. There were significant difficulties in obtaining post-mortem reports and an obvious lack of correlation between coroners' reports and clinical cause of death. Conclusions: The principal cause of mortality in our unit was multi-organ failure due to sepsis, which concurs with current literature. Autopsy has previously been shown to be a useful retrospective diagnostic tool, however we challenge its reliability as a result of our study.

AB - Objective: Global mortality from burns is decreasing however there is a relative paucity of mortality data in the literature from burns units in the United Kingdom. We present an analysis of burns deaths and correlation with coroners' autopsy findings from a large regional burns unit. Design: Retrospective medical note review of patients who died over a 7 year period (January 2005 to April 2011) was undertaken. Patient demographics were recorded in addition to: burn size, depth, length of stay, presence of inhalational injury, organs failing and diagnosis of sepsis. In order to evaluate the accuracy of our pre-mortem clinical diagnosis, we compared post-mortem cause of death with clinical cause of death. Results: There were 92 deaths out of 4745 admissions for acute burn (crude mortality 1.9%). 37 patients were immediately given comfort care and excluded from analysis. Average age was 52.9 years ± 19.4, average percentage burn 43.7% ± 26.8, and length of stay 26.4 ± 45 days. 80% of deaths were attributable to flame burn (44/55), and 51% (28/55) suffered inhalational injury. Multi-organ failure was the primary cause of death (39/55), with sepsis being the primary trigger (20/39, 51%). Pseudomonas was the most common organism isolated in septic patients. There were significant difficulties in obtaining post-mortem reports and an obvious lack of correlation between coroners' reports and clinical cause of death. Conclusions: The principal cause of mortality in our unit was multi-organ failure due to sepsis, which concurs with current literature. Autopsy has previously been shown to be a useful retrospective diagnostic tool, however we challenge its reliability as a result of our study.

KW - Burns

KW - Coroner

KW - Mortality

KW - Multi-organ failure

KW - Sepsis

UR - http://www.scopus.com/inward/record.url?scp=84877099187&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877099187&partnerID=8YFLogxK

U2 - 10.1016/j.burns.2012.09.017

DO - 10.1016/j.burns.2012.09.017

M3 - Article

VL - 39

SP - 583

EP - 588

JO - Burns

JF - Burns

SN - 0305-4179

IS - 4

ER -