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50% body burn used to kill people up to the age of 40 but now half can survive 95% burn

Researchers of a new study are hoping their findings inspire burn units to try to keep people with extensive burns alive as it can be done.

Image: Chaikom

MORE PEOPLE ARE surviving burn injuries thanks to the role advanced burn treatment.

That’s according the findings of a new study published as an article in press on the Journal of the American College of Surgeons website.

Very large burns that cover 50% or more of the body’s surface area put people at high risk of infection and death. Old age, being female and damage to lungs due to the inhalation of smoke also put people at greater risk of death.

David N. Herndon, chief of staff and director of research at the Shriners Hospitals for Children, Galveston, and director of burn services at the University of Texas Medical Branch, is the lead study author.

He said the most dramatic decreases in mortality have been in patients over the age of 40.

Remarkably, a patient up to the age of 40 who has sustained a 95% body burn now survives half the time, whereas in earlier times a 50% body burn killed that same person.

Dr. Herndon and his colleagues examined the records of 10,384 adult and pediatric burn patients admitted to Shriners Hospitals for Children, Galveston, or the Blocker Burn Unit in Galveston from 1989 to 2017.

Of the 10,384 burn admissions, a total of 355 victims died. The researchers looked specifically at the main factors that influenced risk of death in different age groups and then created a risk prediction model.

They found a significant decrease in mortality in their patient population compared with historical predictions from previous studies.

Dr Herndon said: “In this one area of medicine, these new protocols have massively reduced mortality overall.

Over the last 30 years at our burn center there has been a continuing reduction in the risk of mortality of about 2% per year in all age groups, burn sizes, and genders.

The study also identified the most powerful predictors of mortality: the percent of total body surface burned, age and the presence of inhalation injury. The probability of death rose as age increased, as burn size increased, and with the presence of inhalation injury.

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The data suggests that the continuous improvement in mortality over time is a result of changes in the standard of care, including protocols for management of inhalation injury, nutrition to combat infection and aid in healing and receiving early burn excision and skin grafts immediately following injury.

Other factors not assessed in the study that have contributed to better outcomes in burn patients include improvements in the transfer of critically ill patients to hospitals and burn centers.

Dr Herndon added that “a woman over the age of 40, with very large burns, is a patient who can survive today if these protocols are implemented”.

We hope our findings will inspire other burn units to try to keep people alive with extensive burns because it’s clear that it can be done. Burn specialists also need to focus on implementing the protocols that have allowed this improvement in survival to occur.

“Our priorities for future advancements need to focus on decreasing scar tissue and morbidity, effective rehabilitation, and returning patients to work.”

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