Causes of Mortality by Autopsy Findings of Combat Casualties and Civilian Patients Admitted to a Burn Unit

Ruben Gomez, Clinton K. Murray, Duane R. Hospenthal, Leopoldo C. Cancio, Evan M. Renz, John B. Holcomb, Charles E. Wade, Steven Wolf

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Background: Approximately 5% of combat-related injuries include burns. Previous studies have shown similar mortality rates between military and civilian burn casualties; but causes of death were not detailed. Study Design: We retrospectively reviewed autopsy reports of patients with burns treated at the US Army Institute of Surgical Research Burn Center from 2004 to 2007. Results: Of 1,255 admissions, 100 (8%) died, with autopsies performed on 74 (36 burned during military operations). Causes of death included infection (61%); disorders of the pulmonary (55%), cardiac (36%), renal (27%), gastrointestinal (27%), and central nervous (11%) systems; and multiorgan dysfunction (15%). Patients burned as a result of military operations were younger men with more associated inhalation injuries, greater severity of injury, and longer time from injury to admission and to death. They died more frequently of infection (notably fungus, Pseudomonas, and Klebsiella) and gastrointestinal complications; and those not burned in military operations had greater numbers of cardiac and renal causes of death. Conclusion: Casualties of military operations are clinically different and die from different causes than patients not burned during military operations. The differences are likely reflective of a younger population, with greater severity of illness and longer times from injury to admission. Therapeutic interventions should focus on prevention of infection and gastrointestinal catastrophes in military burn casualties, which are similar to younger burn patients in the US, and minimizing cardiac complications in civilian burn casualties, who are typically older patients and possibly reflective of patients with more comorbidities.

Original languageEnglish (US)
Pages (from-to)348-354
Number of pages7
JournalJournal of the American College of Surgeons
Volume208
Issue number3
DOIs
StatePublished - Mar 1 2009
Externally publishedYes

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Burn Units
Autopsy
Mortality
Wounds and Injuries
Cause of Death
Burns
Kidney
Klebsiella
Mycoses
Pseudomonas
Infection
Inhalation
Comorbidity
Central Nervous System
Lung
Population

ASJC Scopus subject areas

  • Surgery

Cite this

Causes of Mortality by Autopsy Findings of Combat Casualties and Civilian Patients Admitted to a Burn Unit. / Gomez, Ruben; Murray, Clinton K.; Hospenthal, Duane R.; Cancio, Leopoldo C.; Renz, Evan M.; Holcomb, John B.; Wade, Charles E.; Wolf, Steven.

In: Journal of the American College of Surgeons, Vol. 208, No. 3, 01.03.2009, p. 348-354.

Research output: Contribution to journalArticle

Gomez, Ruben ; Murray, Clinton K. ; Hospenthal, Duane R. ; Cancio, Leopoldo C. ; Renz, Evan M. ; Holcomb, John B. ; Wade, Charles E. ; Wolf, Steven. / Causes of Mortality by Autopsy Findings of Combat Casualties and Civilian Patients Admitted to a Burn Unit. In: Journal of the American College of Surgeons. 2009 ; Vol. 208, No. 3. pp. 348-354.
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