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Burns. 2013 Jun;39(4):583-8. doi: 10.1016/j.burns.2012.09.017. Epub 2012 Nov 6.

Cause of death and correlation with autopsy findings in burns patients.

Author information

1
Burn Service, St. Andrews Centre for Plastic Surgery and Burns, Chelmsford, Essex CM1 7ET, UK. priya199@hotmail.com

Abstract

OBJECTIVE:

Global mortality from burns is decreasing however there is a relative paucity of mortality data in the literature from burns units in the United Kingdom. We present an analysis of burns deaths and correlation with coroners' autopsy findings from a large regional burns unit.

DESIGN:

Retrospective medical note review of patients who died over a 7 year period (January 2005 to April 2011) was undertaken. Patient demographics were recorded in addition to: burn size, depth, length of stay, presence of inhalational injury, organs failing and diagnosis of sepsis. In order to evaluate the accuracy of our pre-mortem clinical diagnosis, we compared post-mortem cause of death with clinical cause of death.

RESULTS:

There were 92 deaths out of 4745 admissions for acute burn (crude mortality 1.9%). 37 patients were immediately given comfort care and excluded from analysis. Average age was 52.9 years±19.4, average percentage burn 43.7%±26.8, and length of stay 26.4±45 days. 80% of deaths were attributable to flame burn (44/55), and 51% (28/55) suffered inhalational injury. Multi-organ failure was the primary cause of death (39/55), with sepsis being the primary trigger (20/39, 51%). Pseudomonas was the most common organism isolated in septic patients. There were significant difficulties in obtaining post-mortem reports and an obvious lack of correlation between coroners' reports and clinical cause of death.

CONCLUSIONS:

The principal cause of mortality in our unit was multi-organ failure due to sepsis, which concurs with current literature. Autopsy has previously been shown to be a useful retrospective diagnostic tool, however we challenge its reliability as a result of our study.

PMID:
23137628
DOI:
10.1016/j.burns.2012.09.017
[Indexed for MEDLINE]

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