RESUMO
INTRODUCTION: The prevalence of obese adults is rising across the world with a tripling of rates since 1975. The resuscitation of large burns in obese patients brings unique challenges leading some to advocate the use of a bariatric specific burn chart. AIMS: We sought to determine whether bariatric burn specific charts can better estimate burn percentage to prevent under resuscitation. We also reviewed the impact of obesity upon the length of hospital stay, morbidity and mortality at our institution. METHODS: A retrospective case note review, of patients identified from the prospective International Burns Injury Database (iBID), was undertaken of patients' ≥18 years of age with burns ≥15% of their total body surface area. RESULTS: There were 79 overweight and 53 bariatric patients from a total of 232 patients identified. There was no statistical difference in burn percentage or fluid input estimation between the Lund & Browder and Neaman charts. Complications were seen in 51% of the normal weight patients. Obese patients had a similar incidence of death (24%) compared to the normal weight group (26%). The class I obese had the lowest complication rate at 28% and lowest mortality rate at 11%. CONCLUSIONS: Bariatric specific charts did not demonstrate any benefits in optimising bariatric resuscitation. There appears to be a 'physiological benefit' in the class I obese who sustained burns undergoing resuscitation.
