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Hundeshagen, G; Wurzer, P; Forbes, AA; Voigt, CD; Collins, VN; Cambiaso-Daniel, J; Finnerty, CC; Herndon, DN; Branski, LK.
The occurrence of single and multiple organ dysfunction in pediatric electrical versus other thermal burns.
J Trauma Acute Care Surg. 2017; 82(5):946-951
Doi: 10.1097/TA.0000000000001356
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Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
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Branski Ludwik
- Co-Autor*innen der Med Uni Graz
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Cambiaso Daniel Janos
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Wurzer Paul
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- Abstract:
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Multiple organ failure (MOF) is a major contributor to morbidity and mortality in burned children. While various complications induced by electrical injuries have been described, the incidence and severity of single organ failure (SOF) and MOF associated with this type of injury are unknown. The study was undertaken to compare the incidence and severity of SOF and MOF as well as other complications between electrically and thermally burned children.
Between 2001 and 2016, 288 pediatric patients with electrical burns (EB; n = 96) or thermal burns (CTR; n = 192) were analyzed in this study. Demographic data; length of hospitalization; and number and type of operations, amputations, and complications were statistically analyzed. Incidence of SOF and MOF was assessed using the DENVER2 classification in an additive mixed model over time. Compound scores and organ-specific scores for lung, heart, kidney, and liver were analyzed. Serum cytokine expression profiles of both groups were also compared over time. Significance was accepted at p < 0.05.
Both groups were comparable in age (CTR, 11 ± 5 years, vs EB, 11 ± 5 years), percent total body surface area burned (CTR, 33% ± 25%, vs EB, 32 ± 25%), and length of hospitalization (CTR, 18 ± 26 days, vs EB, 18 ± 21 days). The percentage of high-voltage injury in the EB group was 64%. The incidence of MOF was lower in the EB group (2 of 96 [2.1%]) than the CTR group (20 of 192 [10.4%]; p < 0.05). The incidence of single organ failure was comparable between groups. Incidence of pulmonary failure was comparable in both groups, but incidence of inhalation injury was significantly higher in the CTR group (p < 0.0001). Patients in the EB group had more amputations (p < 0.001), major amputations (p = 0.001), and combined major amputations (p < 0.01). Mortality was comparable between the groups. Serum cytokine expression profiles were also comparable between the groups.
In pediatric patients, electrical injury is associated with a lower incidence of MOF than other thermal burns. Early and radical debridement of nonviable tissue is crucial to improve outcomes in the electrical burn patient population.
Retrospective chart review, level III.
- Find related publications in this database (using NLM MeSH Indexing)
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Amputation - statistics & numerical data
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Burns - complications
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Burns - surgery
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Burns, Electric - complications
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Burns, Electric - surgery
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Child -
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Female -
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Heart Failure - epidemiology
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Heart Failure - etiology
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Humans -
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Incidence -
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Length of Stay -
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Liver Failure - epidemiology
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Liver Failure - etiology
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Lung Diseases - epidemiology
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Lung Diseases - etiology
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Male -
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Multiple Organ Failure - epidemiology
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Multiple Organ Failure - etiology
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Renal Insufficiency - epidemiology
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Renal Insufficiency - etiology
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Retrospective Studies -
- Find related publications in this database (Keywords)
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Electrical burn
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organ failure