The leading causes of death after burn injury in a single pediatric burn center.

Felicia N. Williams, David Herndon, Hal K. Hawkins, Jong Lee, Robert A. Cox, Gabriela A. Kulp, Celeste Finnerty, David L. Chinkes, Marc G. Jeschke

Research output: Contribution to journalArticle

136 Citations (Scopus)

Abstract

INTRODUCTION: Severe thermal injury is characterized by profound morbidity and mortality. Advances in burn and critical care, including early excision and grafting, aggressive resuscitation and advances in antimicrobial therapy have made substantial contributions to decrease morbidity and mortality. Despite these advances, death still occurs. Our aim was to determine the predominant causes of death in burned pediatric patients in order to develop new treatment avenues and future trajectories associated with increased survival. METHODS: Primary causes of death were reviewed from 144 pediatric autopsy reports. Percentages of patients that died from anoxic brain injuries, sepsis, or multi-organ failure were calculated by comparing to the total number of deaths. Data was stratified by time (from 1989 to 1999, and 1999 to 2009), and gender. Statistical analysis was done by chi-squared, Student's t-test and Kaplan-Meier for survival where applicable. Significance was accepted as P < 0.05. RESULTS: Five-thousand two-hundred-sixty patients were admitted after burn injury from July 1989 to June 2009, and of those, 145 patients died after burn injury. Of these patients, 144 patients had an autopsy. The leading causes of death over 20 years were sepsis (47%), respiratory failure (29%), anoxic brain injury (16%), and shock (8%). From 1989 to 1999, sepsis accounted for 35% of deaths but increased to 54% from 1999 to 2009, with a significant increase in the proportion due to antibiotic resistant organisms (P < 0.05). CONCLUSIONS: Sepsis is the leading cause of death after burn injury. Multiple antibiotic resistant bacteria now account for the bulk of deaths due to sepsis. Further improvement in survival may require improved strategies to deal with this problem.

Original languageEnglish (US)
JournalCritical care (London, England)
Volume13
Issue number6
StatePublished - 2009

Fingerprint

Burn Units
Cause of Death
Sepsis
Pediatrics
Wounds and Injuries
Brain Injuries
Survival
Autopsy
Anti-Bacterial Agents
Morbidity
Mortality
Kaplan-Meier Estimate
Critical Care
Resuscitation
Respiratory Insufficiency
Shock
Hot Temperature
Students
Bacteria
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Williams, F. N., Herndon, D., Hawkins, H. K., Lee, J., Cox, R. A., Kulp, G. A., ... Jeschke, M. G. (2009). The leading causes of death after burn injury in a single pediatric burn center. Critical care (London, England), 13(6).

The leading causes of death after burn injury in a single pediatric burn center. / Williams, Felicia N.; Herndon, David; Hawkins, Hal K.; Lee, Jong; Cox, Robert A.; Kulp, Gabriela A.; Finnerty, Celeste; Chinkes, David L.; Jeschke, Marc G.

In: Critical care (London, England), Vol. 13, No. 6, 2009.

Research output: Contribution to journalArticle

Williams, FN, Herndon, D, Hawkins, HK, Lee, J, Cox, RA, Kulp, GA, Finnerty, C, Chinkes, DL & Jeschke, MG 2009, 'The leading causes of death after burn injury in a single pediatric burn center.', Critical care (London, England), vol. 13, no. 6.
Williams, Felicia N. ; Herndon, David ; Hawkins, Hal K. ; Lee, Jong ; Cox, Robert A. ; Kulp, Gabriela A. ; Finnerty, Celeste ; Chinkes, David L. ; Jeschke, Marc G. / The leading causes of death after burn injury in a single pediatric burn center. In: Critical care (London, England). 2009 ; Vol. 13, No. 6.
@article{01288fd4c1e143caa582c7cb395523b9,
title = "The leading causes of death after burn injury in a single pediatric burn center.",
abstract = "INTRODUCTION: Severe thermal injury is characterized by profound morbidity and mortality. Advances in burn and critical care, including early excision and grafting, aggressive resuscitation and advances in antimicrobial therapy have made substantial contributions to decrease morbidity and mortality. Despite these advances, death still occurs. Our aim was to determine the predominant causes of death in burned pediatric patients in order to develop new treatment avenues and future trajectories associated with increased survival. METHODS: Primary causes of death were reviewed from 144 pediatric autopsy reports. Percentages of patients that died from anoxic brain injuries, sepsis, or multi-organ failure were calculated by comparing to the total number of deaths. Data was stratified by time (from 1989 to 1999, and 1999 to 2009), and gender. Statistical analysis was done by chi-squared, Student's t-test and Kaplan-Meier for survival where applicable. Significance was accepted as P < 0.05. RESULTS: Five-thousand two-hundred-sixty patients were admitted after burn injury from July 1989 to June 2009, and of those, 145 patients died after burn injury. Of these patients, 144 patients had an autopsy. The leading causes of death over 20 years were sepsis (47{\%}), respiratory failure (29{\%}), anoxic brain injury (16{\%}), and shock (8{\%}). From 1989 to 1999, sepsis accounted for 35{\%} of deaths but increased to 54{\%} from 1999 to 2009, with a significant increase in the proportion due to antibiotic resistant organisms (P < 0.05). CONCLUSIONS: Sepsis is the leading cause of death after burn injury. Multiple antibiotic resistant bacteria now account for the bulk of deaths due to sepsis. Further improvement in survival may require improved strategies to deal with this problem.",
author = "Williams, {Felicia N.} and David Herndon and Hawkins, {Hal K.} and Jong Lee and Cox, {Robert A.} and Kulp, {Gabriela A.} and Celeste Finnerty and Chinkes, {David L.} and Jeschke, {Marc G.}",
year = "2009",
language = "English (US)",
volume = "13",
journal = "Critical Care",
issn = "1364-8535",
publisher = "BioMed Central Ltd.",
number = "6",

}

TY - JOUR

T1 - The leading causes of death after burn injury in a single pediatric burn center.

AU - Williams, Felicia N.

AU - Herndon, David

AU - Hawkins, Hal K.

AU - Lee, Jong

AU - Cox, Robert A.

AU - Kulp, Gabriela A.

AU - Finnerty, Celeste

AU - Chinkes, David L.

AU - Jeschke, Marc G.

PY - 2009

Y1 - 2009

N2 - INTRODUCTION: Severe thermal injury is characterized by profound morbidity and mortality. Advances in burn and critical care, including early excision and grafting, aggressive resuscitation and advances in antimicrobial therapy have made substantial contributions to decrease morbidity and mortality. Despite these advances, death still occurs. Our aim was to determine the predominant causes of death in burned pediatric patients in order to develop new treatment avenues and future trajectories associated with increased survival. METHODS: Primary causes of death were reviewed from 144 pediatric autopsy reports. Percentages of patients that died from anoxic brain injuries, sepsis, or multi-organ failure were calculated by comparing to the total number of deaths. Data was stratified by time (from 1989 to 1999, and 1999 to 2009), and gender. Statistical analysis was done by chi-squared, Student's t-test and Kaplan-Meier for survival where applicable. Significance was accepted as P < 0.05. RESULTS: Five-thousand two-hundred-sixty patients were admitted after burn injury from July 1989 to June 2009, and of those, 145 patients died after burn injury. Of these patients, 144 patients had an autopsy. The leading causes of death over 20 years were sepsis (47%), respiratory failure (29%), anoxic brain injury (16%), and shock (8%). From 1989 to 1999, sepsis accounted for 35% of deaths but increased to 54% from 1999 to 2009, with a significant increase in the proportion due to antibiotic resistant organisms (P < 0.05). CONCLUSIONS: Sepsis is the leading cause of death after burn injury. Multiple antibiotic resistant bacteria now account for the bulk of deaths due to sepsis. Further improvement in survival may require improved strategies to deal with this problem.

AB - INTRODUCTION: Severe thermal injury is characterized by profound morbidity and mortality. Advances in burn and critical care, including early excision and grafting, aggressive resuscitation and advances in antimicrobial therapy have made substantial contributions to decrease morbidity and mortality. Despite these advances, death still occurs. Our aim was to determine the predominant causes of death in burned pediatric patients in order to develop new treatment avenues and future trajectories associated with increased survival. METHODS: Primary causes of death were reviewed from 144 pediatric autopsy reports. Percentages of patients that died from anoxic brain injuries, sepsis, or multi-organ failure were calculated by comparing to the total number of deaths. Data was stratified by time (from 1989 to 1999, and 1999 to 2009), and gender. Statistical analysis was done by chi-squared, Student's t-test and Kaplan-Meier for survival where applicable. Significance was accepted as P < 0.05. RESULTS: Five-thousand two-hundred-sixty patients were admitted after burn injury from July 1989 to June 2009, and of those, 145 patients died after burn injury. Of these patients, 144 patients had an autopsy. The leading causes of death over 20 years were sepsis (47%), respiratory failure (29%), anoxic brain injury (16%), and shock (8%). From 1989 to 1999, sepsis accounted for 35% of deaths but increased to 54% from 1999 to 2009, with a significant increase in the proportion due to antibiotic resistant organisms (P < 0.05). CONCLUSIONS: Sepsis is the leading cause of death after burn injury. Multiple antibiotic resistant bacteria now account for the bulk of deaths due to sepsis. Further improvement in survival may require improved strategies to deal with this problem.

UR - http://www.scopus.com/inward/record.url?scp=77951626778&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77951626778&partnerID=8YFLogxK

M3 - Article

C2 - 19919684

AN - SCOPUS:77951626778

VL - 13

JO - Critical Care

JF - Critical Care

SN - 1364-8535

IS - 6

ER -