Mortality and causes of death of Dutch burn patients during the period 2006-2011.

INTRODUCTION: Mortality of burn patients has decreased in the last decades. Literature indicates that the leading cause of death in late mortality is multiple organ failure (MOF), but literature is not clear about the cause of early mortality. The aim of this study was to determine the mortality and causes of death of burn patients in Dutch burn centers between January 2006 and December 2011. METHODS: A retrospective study was performed in patients who died between January 2006 and December 2011 in the burn centers of Rotterdam and Beverwijk, the Netherlands. In this period 2730 patients were admitted. RESULTS: Of these 2730 patients, 88 patients died as a result of their burn injury. The overall mortality rate was 3.2%. The palliative care group, defined as patients receiving no curative ('active') care and leading to early death (<48h), consisted of 28 patients (31.8%, 28 out of 88 patients). The most common cause of late mortality (>48h, in 60 out of 88 patients, 68.2%) was MOF (38.3%, 23 out of 60 patients). One important significant difference between the early and late mortality groups was a higher Baux score in the palliative care group compared to the withdrawal of and active treatment groups. There were no significant differences when the groups were compared regarding the presence of inhalation trauma. CONCLUSIONS: Mortality in burn patients has decreased. Most deaths occur early, in patients who receive only palliative care. In late mortality, MOF is the most common cause of death.

Outcome after burns: an observational study on burn scar maturation and predictors for severe scarring.

Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in relation to the depth, etiology of the burn wound and age of the patient. Burn scars of 474 patients were subjected to a scar assessment protocol 3, 6, and 12 months postburn. Three different age groups were defined (≤5, 5-18, and ≥18 years). The observer part of the patient and observer scar assessment scale revealed a significant (p < 0.001) improvement in scar quality at 12 months compared with the 3- and 6-month data. Predictors for severe scarring are depth of the wound (p < 0.001) and total body surface area burned (p < 0.001). Etiology (p = 0.753) and age (p > 0.230) have no significant influence on scar quality when corrected for sex, total body surface area burned, time, and age or etiology, respectively.