The authors analyze death cases from deep burns at the Pediatric Burn Center of the town of Saratov in 1978-1992. A relationship between mortality rate, on the one hand, and the size and site of the injury and patients' age, on the other, was revealed. "Critical days" of burn disease were distinguished, which are characterized by increased number of lethal cases. Stages of burn disease were defined, as were the main causes of death. Histologic changes in organs and tissues of the victims are described.
Fire-related fatalities and injuries have become a growing governmental concern in Sweden, and a national vision zero strategy has been adopted stating that nobody should get killed or seriously injured from fires. There is considerable uncertainty, however, regarding the numbers of both deaths and injuries due to fires. Different national sources present different numbers, even on deaths, which obstructs reliable surveillance of the problem over time. We assume the situation is similar in other countries. This study seeks to assess the true number of fire-related deaths in Sweden by combining sources, and to verify the coverage of each individual source. By doing so, we also wish to demonstrate the possibilities of improved surveillance practices.
Data from three national sources were collected and matched; a special database on fatal fires held by The Swedish Contingencies Agency (nationally responsible for fire prevention), a database on forensic medical examinations held by the National Board of Forensic Medicine, and the cause of death register held by the Swedish National Board of Health and Welfare.
The results disclose considerable underreporting in the single sources. The national database on fatal fires, serving as the principal source for policy making on fire prevention matters, underestimates the true situation by 20%. Its coverage of residential fires appears to be better than other fires.
Systematic safety work and informed policy-making presuppose access to correct and reliable numbers. By combining several different sources, as suggested in this study, the national database on fatal fires is now considerably improved and includes regular matching with complementary sources.
About 800 patients are admitted annually to Norwegian hospitals for burn injuries. Among these, about 5% (40) patients have extensive burns, and 80-110 have special burns (skinburns combined with inhalation injuries, burns of the hands and burns of the face). The National Burn Center at Haukeland Hospital was opened in October 1984. In our experience decreased mortality, reduced disability and quicker rehabilitation are achieved when extensive and special burns are treated in specialized burn units.
To delineate blood transfusion practices and outcomes in patients with major burn injury.
Patients with major burn injury frequently require multiple blood transfusions; however, the effect of blood transfusion after major burn injury has had limited study.
Multicenter retrospective cohort analysis.
Regional burn centers throughout the United States and Canada.
Patients admitted to a participating burn center from January 1 through December 31, 2002, with acute burn injuries of >or=20% total body surface area.
Outcome measurements included mortality, number of infections, length of stay, units of blood transfused in and out of the operating room, number of operations, and anticoagulant use.
A total of 21 burn centers contributed data on 666 patients; 79% of patients survived and received a mean of 14 units of packed red blood cells during their hospitalization. Mortality was related to patient age, total body surface area burn, inhalation injury, number of units of blood transfused outside the operating room, and total number of transfusions. The number of infections per patient increased with each unit of blood transfused (odds ratio, 1.13; p
Notes
Comment In: Crit Care Med. 2006 Jun;34(6):1822-316714983
