Determinants of mortality in pediatric patients with greater than 70% full-thickness total body surface area thermal injury treated by early total excision and grafting

David N. Herndon, Dennis Gore, Melvin Cole, Manu H. Desai, Hugo Linares, Sally Abston, Thomas Rutan, Tim Van Osten, Robert E. Barrow

Research output: Contribution to journalArticle

98 Scopus citations

Abstract

Recent advancements in burn care have improved the survival rates of victims with severe burn injuries. The total mortality rate in a series of 1, 057 pediatric patients admitted to Shriners Burns Institute Galveston Unit between 1982 and 1986 was 2.7%. The burn size resulting in a 50% death rate was 95% of the total body surface area (TBSA). In this study 19 survivors and 13 nonsurvivors with greater than 70% full-thickness TBSA burn injuries were compared. All survivors were adequately resuscitated upon arrival 11 % sustained an inhalation injury. Forty-six per cent of the nonsurvivors sustained an inhalation injury; 31% were not initially adequately resuscitated. The presence of preadmission shock and inhalation injury were early determinants of mortality with secondary renal, pulmonary, or cardiovascular collapse being the later predictors of mortality in these massively burned pediatric patients.

Original languageEnglish (US)
Pages (from-to)208-212
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume27
Issue number2
DOIs
StatePublished - Feb 1987

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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