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Worst burn victims12/2/2023 ![]() The records of interest for this study included infectious and non-infectious complications. Timing of wound excision and grafting was decided by surgeons and intensivists based on evaluation of burns and patient's resuscitation. Inhalation injury was defined by the following: history of burn occurring in an enclosed space singeing of facial hair soot in the oral pharynx inflammation of the lower airway on fiberoptic broncoscopy. Demographic data (age, gender), severity of illness (SAPS II, Simplified Acute Physiology Score and SOFA, Sequential Organ Failure Assessment) on admission, medical comorbidities using Charlson Comorbidity Index Score, % TBSA burned, Baux index (age plus %TBSA burned), degree of burn, location of burns, aetiology of injury, presence of inhalation injury, timing of wound excision and grafting, length of ICU stay, short term mortality (ICU and hospital mortality), were recorded for each patient. The ICU has four medical staff members participating in continuing medical education of burn patients, mainly nurses (two nurses for one patient) and nursing auxiliary staff members (one for each patient).Īfter obtaining the approval of the Research Ethical Committee of University-Hospital of Padova and the written consent of the patients or their relatives, during a 5-year period (from 1 January 1999 to 31 December 2003), all adult severe burn patients (TBSA > 40%) admitted to the ICU and requiring mechanical ventilation (MV) were prospectively included in the study. In this hospital, that represents the reference center for adult burn patients throughout the north east of Italy, there is a specialized burn unit for non intubated burn patients attended by staff plastic surgeons with burns care experience and a polyvalent ICU (16 beds) with two isolated-single bed rooms dedicated to ventilated severe burn patients under the supervision of intensivists. ![]() This study was performed in the Department of Intensive Care (ICU) of academic hospital of Padova. The second objective was to determine their health related quality of life (HR-QoL) one year after the injury, using the EQ-5D questionnaire. The primary aim of this study was prospectively to evaluate the short and the long term mortality of severe burn patients (TBSA > 40%) admitted to the ICU and requiring ventilatory support we also identified which clinical factors at the time of injury would predict in-hospital mortality. One such instrument could be the EuroQol-5D (EQ-5D) which is a simple questionnaire used by a number of patients with specific diseases, including critically ill patients it is validated in burn patients and used to provide information on the costs of the different type of burn treatment. The instrument must aim to be simple and easy to use. Nevertheless this questionnaire is rather long and some authors have criticized it as being laborious to use. ![]() It includes both physical and psychosocial domains. This questionnaire was designed to assess the post-injury adjustment by means of health-related quality of life in adult burn survivors. One of the few specific instruments that were used to support such an effort was the Burn Specific Health Scale (BSHS), validated and finalised into an abbreviated 80-item version. To better understand the impact of morbidity and consequences of thermal injury and to evaluate clinical programs for treatment and follow-up, assessment of burn patient health status and quality of life have been advocated. Somatic symptoms are generally persistent and psychiatric disorders such as post-traumatic stress disorders (PTSD) and depression are relatively frequent. Burn survivors often have a challenging and protracted recovery process. In addition, altered appearance and stigmatization may represent a threat to patient social life. Burn injury may affect all aspects of human life, leaving survivors with a variety of physical and psychosocial handicaps. Hence it is important to identify injury- and treatment-related factors influencing survival of patients with severe burns.Ī number of factors outside the control of the burn service may also influence outcome, including motivation of the patient, pre-burn psychological morbidity, family support and socio-economic background. Attempts to provide valid and objective estimates of the risk of death following burn have a long and extensive history, yet little has changed during the time. īurn patients are an heterogeneous population, with wide variation in age, mechanism of injury, depth and site of burn and a different co-morbidity. data indicate a 69% mortality rate among patients with burns over 70% of TBSA. Some publications have suggested that survival rates reach 50% in young adults sustaining a Total Body Surface Area (TBSA) burned of 80% without inhalation injury. The treatment of patients with extensive burns remains a major challenge, even with advances in burn care over recent decades.
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