Occurrence of multiorgan dysfunction in pediatric burn patients: Incidence and clinical outcome

Robert Kraft, David N. Herndon, Celeste C. Finnerty, Shahriar Shahrokhi, Marc G. Jeschke

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

OBJECTIVE:: To examine the incidence of single or multiple organ failure postburn and its resultant clinical outcomes during acute hospitalization. BACKGROUND:: Patient outcomes are inherently dependent on intact organ function; however, burn injury affects the structure and function of almost every organ, but especially lung, liver, kidney, and heart. Therefore, single-organ failure and/or multiorgan failure (MOF) are thought to contribute significantly to postburn morbidity and mortality, but to date no large trial examining the effects of MOF on postburn outcomes exists. METHODS:: Incidence of MOF was monitored in 821 pediatric burn patients during acute hospitalization. Patients were divided into groups on the basis of the incidence of single-organ-specific failure, MOF, and non-MOF. The DENVER2 score was used to assess organ-specific scores for lung, liver, kidney, and heart. The patient's demographics, injury characteristics, and outcome parameters were recorded. RESULTS:: Respiratory failure has the highest incidence in the early phase of postburn injury and decreases starting 5 days postburn. Cardiac failure was noted to have the highest incidence throughout hospital stay. Incidence of hepatic failure increases with the hospital length of stay and is associated with a high mortality during the late phase of the acute hospital stay. Renal failure has an unexpectedly low incidence but is associated with a high mortality during the first 3 weeks postburn injury. Three or more organ failure is associated with very high mortality. CONCLUSIONS:: This is the first large study in burn patients to determine the incidence of organ-specific failure and outcome. The results of this study confirmed the expected chronologic incidence of organ-specific failure and yield the long-term mortality from liver and renal failure (NCT00673309).

Original languageEnglish (US)
Pages (from-to)381-387
Number of pages7
JournalAnnals of surgery
Volume259
Issue number2
DOIs
StatePublished - Feb 1 2014

Keywords

  • burn
  • hypermetabolism
  • inflammation
  • morbidity
  • mortality
  • organ failure

ASJC Scopus subject areas

  • Surgery

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