17 June 2021
A more effective and tailored treatment for sufferers of severe burns could soon be available. KAIMRC researchers have assessed the mortality rates of burn patients in need of mechanical ventilation and identified factors contributing to their survival.
Burns affect the skin or other tissues to various degrees. Minor burns, which involve the surface of the skin and some underlying layers, can heal rapidly with only pain medication. Major burns spread to all skin layers and to deeper tissues, such as muscles, organs, and bones, and often lead to the loss of the burned area. These life-threatening injuries require intensive and prolonged treatment in a specialized unit.
State-of-the-art critical care methods and dedicated teams have substantially reduced the mortality rate of burn patients. To ensure that a patient’s vital signs are stable, intensive care treatment typically starts with intubation and mechanical ventilation, which are essential to ensure that severely burnt patients can breathe without difficulty. Nonetheless, mortality rates remain quite high.
Fatmah Othman, who led the study, says that data on the survival of burn patients admitted to intensive care units and requiring mechanical ventilation varies widely, and information on this topic is also scarce at the national level. The researchers evaluated the mortality rate of 356 patients admitted to the burn units of King Abdulaziz Medical City and King Abdullah Specialist Children’s Hospital between January 2016 and July 2019. Eighty of these patients received mechanical ventilation because of inhalation injury.
More than 95% of the admitted patients survived their injury, a better rate than in other developing countries. “This can be explained by our highly advanced practices and specialized team,” Othman says. Unfortunately, 20% of the mechanically ventilated cohort died.
Patients older than 14 had a higher mortality rate than younger patients, probably due to differences in physiological mechanisms and immune responses. Othman says that comorbidities, which are more prevalent in the non-survivor group, can also increase mortality rates in older patients.
Burns exceeding 60% of the body resulted in a higher mortality rate than minor injuries. Inhalation injury and medical complications extending the hospital stay also aggravated the mortality rate. In particular, ventilator-associated pneumonia, organ failure, and sepsis – a body’s severe response to infection that destroys its own tissues and organs – were the most significant causes of death in mechanically ventilated patients.
The team plans to expand this study to other centres around the Kingdom.
- Ismaeil, T., et al. Survival analysis of mechanically ventilated patients in the burn unit at King Abdulaziz Medical City in Riyadh 2016-2019. International Journal of Burns and Trauma 10, 169–173 (2020). | article