ABSTRACT
BACKGROUND: Approximately 150 subjects per year suffer severe burns in Chile. AIM: To analyze sociodemographic/clinical features and outcomes of severely burned patients. MATERIAL AND METHODS: Retrospective cohort study of 936 patients aged 47 ± 20 years (66% males), admitted to the National Burn Center of Chile between 2006 and 2010. Sociodemographic/clinical and burn variables and outcomes were studied. RESULTS: Mean total percentage of body surface area burned was 27 + 20%. A quarter of the patients had social features that could jeopardize rehabilitation. Fire was the burning agent in 73%, which along with electricity presented greater lethality (p < 0.01). Inhalation injury was diagnosed in 22% of the patients. Twenty eight percent of patients had impaired consciousness at the moment of the accident, leading to larger burns, higher incidence of inhalation injury and greater lethality. Lethality for severe, critical and exceptional survival groups was 8.4,37.7 and 70.4%, respectively. CONCLUSIONS: Severely burned patients in Chile are mainly males at working age. Fire is the main agent and 28% had impaired consciousness, which was associated with an increase in the severity of burns. Knowledge of the characteristics and outcomes of the patients is important to implement prevention and treatment strategies adjusted to the national reality.
Subject(s)
Burn Units/statistics & numerical data , Burns/mortality , Hospitalization/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Body Surface Area , Burns/etiology , Burns/pathology , Burns/therapy , Chile/epidemiology , Cohort Studies , Female , Fires , Humans , Male , Middle Aged , Retrospective Studies , Severity of Illness Index , Socioeconomic Factors , Young AdultABSTRACT
Background: Approximately 150 subjects per year suffer severe burns in Chile. Aim: To analyze sociodemographic/clinical features and outcomes of severely burned patients. Material and Methods: Retrospective cohort study of 936 patients aged 47 ± 20 years (66% males), admitted to the National Burn Center of Chile between 2006 and 2010. Sociodemographic/clinical and burn variables and outcomes were studied. Results: Mean total percentage of body surface area burned was 27 + 20%. A quarter of the patients had social features that could jeopardize rehabilitation. Fire was the burning agent in 73%, which along with electricity presented greater lethality (p < 0.01). Inhalation injury was diagnosed in 22% of the patients. Twenty eight percent of patients had impaired consciousness at the moment of the accident, leading to larger burns, higher incidence of inhalation injury and greater lethality. Lethality for severe, critical and exceptional survival groups was 8.4,37.7 and 70.4%, respectively. Conclusions: Severely burned patients in Chile are mainly males at working age. Fire is the main agent and 28% had impaired consciousness, which was associated with an increase in the severity of burns. Knowledge of the characteristics and outcomes of the patients is important to implement prevention and treatment strategies adjusted to the national reality.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Burn Units/statistics & numerical data , Burns/mortality , Hospitalization/statistics & numerical data , Body Surface Area , Burns/etiology , Burns/pathology , Burns/therapy , Chile/epidemiology , Cohort Studies , Fires , Retrospective Studies , Severity of Illness Index , Socioeconomic FactorsABSTRACT
BACKGROUND: Electrical burns are associated with complications and may aggravate burned patients. AIM: To evaluate the effect of electrical burns in mortality and length of stay in a critical care unit for burn patients. MATERIAL AND METHODS: Retrospective analysis of medical records of 182 patients aged 15 to 90 years, admitted to an intensive care unit for burn patients. The length of stay and mortality of 14 patients that suffered electric burns was compared with the features of 168 patients with other type of burns. RESULTS: Patients with electrical burns were younger, had a lower percentage of total body surface burnt and had a lower frequency of inhalatory injuries than their counterparts with other type of burns. Mortality rate among patients with electric or other types of burns was similar (three and 49 patients, respectively). Intensive care unit stay was also similar. A multivariate analysis showed that high voltage electric burns were an independent risk factor for death with an odds ratio of 12 (95% confidence intervals 1.8-79.4). CONCLUSIONS: High voltage electric burns are an independent risk factor for death among burn patients.
Subject(s)
Burns, Electric/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Chile/epidemiology , Female , Hospital Mortality , Humans , Length of Stay , Male , Middle Aged , Retrospective Studies , Risk Factors , Young AdultABSTRACT
Las neumonías adquiridas en la comunidad son frecuentes y debidas, en un considerable porcentaje de lo casos, a pneumococcus, pudiendo ser tratadas satisfactoriamente con penicilina, sin necesidad de hospitalización. Sin embargo, su mortalidad global oscila entre un 1 y 5 por ciento. En consecuencia, es importante precisar cuales son los factores de riesgo que agravan el pronóstico y que favorecen las complicaciones y, por tanto, reconocer cuales son los pacientes que deben ser hospitalizados. Entre estos factores destacan la edad mayor de 60 años y la patología orgánica concomitante, destacando la diabetes, la enfermedad bronquial obstructiva crónica, la desnutrición y el alcoholismo. son igualmente factores de importancia pronóstica la temperatura elevada, la taquipnea mayor de 30 respiraciones por minuto, la hipotensión arterial y la hipoxemia. La decisión de hospitalización deriva de la correcta evaluación de estos factores de riesgo en cada caso particular
Subject(s)
Humans , Pneumonia/complications , Risk Factors , Hospitalization/trends , Physical Examination , Predictive Value of Tests , Prognosis , Risk GroupsABSTRACT
La neumonía del adulto mayor es una afección frecuente y seria, que tiene características especiales en sus manifestaciones clínicas; en su expresión semiológica y radiológica y en su comportamiento en lo que respecta a evolución, resolución y respuesta al tratamiento antibiótico. Lo anterior se debe a las modificaciones provocadas por la edad y las afecciones crónicas en los mecanismos defensivos celulares y humorales frente a las infecciones respiratorias bacterianas y virales. Dado que su pronóstico depende en gran medida de la oportunidad del tratamiento antibiótico, se enfatiza la necesidad de sospechar y pesquisar la posibilidad de neumopatía aguda, en el sujeto de edad aún frente a manifestaciones clínicas atípicas y larvadas. Se hace hincapié, asimismo, en la utilidad pero también en las limitaciones de los exámenes bacteriológicos y de la radiografía de tórax. Se señala la utilidad de los tratamientos antibióticos asociados. Finalmente se mencionan las principales complicaciones, destacando, entre ellas, la resolución lenta o aún la no resolución de algunas neumonías del anciano, enumerando sus principales causas
