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Mirahmadizadeh A, Moftakhar L, Dehghani SS, Hassanzadeh J, Dehghani SP, Azarbakhsh H. Mortality Rate and Years of Life Lost Due to Burns in Southern Iran During 2004-2019: A Population-Based Study. ARCHIVES OF IRANIAN MEDICINE 2023; 26:205-211. [PMID: 38301080 PMCID: PMC10685748 DOI: 10.34172/aim.2023.31] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 12/12/2022] [Indexed: 02/03/2024]
Abstract
BACKGROUND Burns constitute one of the most important etiologies of infection and mortality worldwide, with the most significant number of cases in low- and middle-income countries. This is a cross-sectional study on deaths due to burns in southern Iran. METHODS In this study, data on all deaths due to burns in southern Iran between 2004 and 2019 was extracted from the population-based Electronic Death Registry System (EDRS). The Joinpoint Regression method was used to examine the trend of crude mortality rate, standardized mortality rate, and years of life lost (YLL) rate. In order to measure YLL, the number of deaths and life expectancy for different age and gender groups were used, for which the standard life table was considered. RESULTS During this study, 2175 deaths due to burns occurred, 50.6% (1106 cases) of which were in men and 38.7% (841 cases) were in the 15-29 age group. The crude and the standardized mortality rate had a decreasing trend during the study years. The total number of YLL was 25260 (0.8 per 1000) in men, 25,785 (0.8 per 1000) in women, and 51,045 (0.8 per 1000) in both genders during the 16 years of the study. CONCLUSION Considering the high mortality rate in the 15-29 age group, which consists of the active and productive labor force, necessary actions are needed in order to improve safety equipment and to make the workplace safe.
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Affiliation(s)
- Alireza Mirahmadizadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Moftakhar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Jafar Hassanzadeh
- Research Center for Health Sciences, Institute of Health, Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
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Sachkov AV, Spiridonova TG, Zhirkova EA, Medvedev AV, Rogal ML. [Serum creatine phosphokinase as a predictor of upper limb amputation in electrical trauma]. Khirurgiia (Mosk) 2023:47-52. [PMID: 37186650 DOI: 10.17116/hirurgia202305147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To study the relationship between serum creatine phosphokinase and outcomes of injury in victims with electrical burns. MATERIAL AND METHODS Among 40 patients with electrical injury, 7 (18%) ones underwent upper limb amputation. There were 37 (92.5%) men and 3 (7.5%) women aged 37 (28; 47) years. We analyzed total serum creatine phosphokinase and MB fraction on the first day in patients with and without amputations. RESULTS Total serum creatine phosphokinase exceeded the upper reference value in 11 out of 33 patients without amputation and in all 7 patients with limb amputation (p=0.001). Patients with limb amputation had significantly higher total serum creatine phosphokinase and MB fraction (p<0.001 and p=0.030, respectively). Logistic regression equation showed that high total serum creatine phosphokinase significantly influenced amputation rate (p<0.001), as evidenced by odds ratio (42.7, 95% CI 3.5-514.8). ROC analysis revealed the cut-off value of total serum creatine phosphokinase (950 IU/L). Sensitivity was 100% (63; 100), specificity - 94% (86; 94), positive predictive value - 78% (49; 78), negative predictive value - 100% (92; 100). CONCLUSION Total serum creatine phosphokinase depends only on severity of electrical and flame burns. Serum creatine phosphokinase is a predictor of upper limb amputation in patients with electrical injury. Total serum creatine phosphokinase ≥ 950 IU/L is significant for upper limb amputation (in CK-MB fraction within the reference values).
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Affiliation(s)
- A V Sachkov
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - T G Spiridonova
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - E A Zhirkova
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - A V Medvedev
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - M L Rogal
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
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Reconstruction of Severe Neck Scar Contracture After Electrical Injury. J Craniofac Surg 2021; 33:203-205. [PMID: 34267134 DOI: 10.1097/scs.0000000000007852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
ABSTRACT High-voltage (≥1000 V) electrical injury is always related to high mortality and poor prognosis. The incidence rates of the high-voltage electrical injuries of the neck are lower than those of the other parts of the body. This article reports a case of the reconstruction of severe neck scar contracture after electrical injury. Compared with cases of scar contractures caused by nonelectrical injuries, this case had the following remarkable characteristics: extremely severe difficult airway, contracture scars involving whole layers of tissue, muscle and nerve damage, mandibular retraction, and poor occlusal relationship. The chief complaints of the patient upon admission, including forced position and continuous salivation, were greatly relieved through several operations by using different kinds of flaps and offering support to the flap from the palmar tendon and relocated mandible. However, the problem of salivation was incompletely solved. This problem might be caused by damage to related nerves and masticatory muscle function caused by high-voltage electrical injury. The patient was satisfied with the recovery of his appearance and movement function.
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Wang W, Zhang J, Lv Y, Zhang P, Huang Y, Xiang F. Epidemiological Investigation of Elderly Patients with Severe Burns at a Major Burn Center in Southwest China. Med Sci Monit 2020; 26:e918537. [PMID: 31905188 PMCID: PMC6977601 DOI: 10.12659/msm.918537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background The treatment of elderly patients with severe burns is difficult and the mortality rate is high. The aim of this study was to investigate the epidemiological features of elderly patients with severe burns. Material/Methods Data from 109 elderly patients with severe burns between January 2009 and December 2018 were retrospectively analyzed. Demographic data, clinical characteristics, treatments, and outcomes were statistically analyzed. Results Among the 109 elderly patients with severe burns, the male-to-female ratio was 1.73: 1.0. The median age of the elderly patients was 67 years, and the median total body surface area (TBSA) burned was 42%. Notably, 67.9% of burns occurred at home and most frequently occurred in summer (38.5%) and winter (28.4%); flame and flash burns predominated (83.4%). The incidence of inhalation injury was 35.8%, and pre-existing comorbidities were observed in approximately 51.4% of the patients. The median length of stay in the hospital per TBSA burned was 0.4 days. The mortality rate in the elderly patients was 24.8%, and the mortality rates in the ≥70% TBSA group, inhalation injury group, and patients with 3 or more pre-existing comorbidities were significantly higher than in the other groups. The risk of death increased with an increase in the number of pre-existing comorbidities (odds ratio: 2.222; 95% confidence interval: 1.174–4.205). Conclusions At a major burn center in Southwest China, the incidence and mortality of elderly patients with severe burns displayed no downward trend. There are etiological characteristics of these age groups that should be considered for prevention. Meanwhile, multidisciplinary treatment in a hospital and an increase in the social support for the elderly population might improve outcomes.
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Affiliation(s)
- Wensheng Wang
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China (mainland)
| | - Junhui Zhang
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China (mainland)
| | - Yanling Lv
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China (mainland)
| | - Peng Zhang
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China (mainland)
| | - Yuesheng Huang
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China (mainland)
| | - Fei Xiang
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China (mainland)
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Shawon RA, Mashreky SR. A response letter to the editor on mechanism classification of fatal injuries. Burns 2019; 46:253-254. [PMID: 31859089 DOI: 10.1016/j.burns.2019.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/02/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Riffat Ara Shawon
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh.
| | - Saidur Rahman Mashreky
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh; Dept. of Non-Communicable Diseases, Bangladesh University of Health Sciences, Bangladesh.
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McInnes JA, Cleland HJ, Cameron PA, Darton A, Tracy LM, Wood FM, Singer Y, Gabbe BJ. Epidemiology of burn-related fatalities in Australia and New Zealand, 2009–2015. Burns 2019; 45:1553-1561. [DOI: 10.1016/j.burns.2019.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/03/2019] [Accepted: 07/02/2019] [Indexed: 10/26/2022]
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Rubio-Gallegos F, Núñez-González S, Gault C, Simancas-Racines D, Basantes-García E. McGregor inguinal flap for coverage of large soft tissue losses due to high-voltage electrical burns in the upper limb: a retrospective study. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2019; 9:52-58. [PMID: 31333895 PMCID: PMC6627789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/13/2019] [Indexed: 06/10/2023]
Abstract
High-voltage electrical burns are potentially devastating and they are associated with significant morbidity and mortality. Due to vascular damage and progressive tissue necrosis produced by electrical burns, there is a large controversy regarding the ideal reconstructive technique for cutaneous coverage of severe lesions in the upper limb. This study aims to analyze our experience using the McGregor inguinal flap technique, for the coverage of large soft tissue losses produced by high-voltage electric burns in the upper limb. We performed a retrospective descriptive study with patients diagnosed with high-voltage electric burns, in which the McGregor inguinal flap technique was used to cover severe lesions in the upper limb. This study was performed at the department of Reconstructive Plastic Surgery and Burns of the Specialist Hospital Eugenio Espejo, from January 2016 to December 2017. The flap technique was performed on twelve patients, out of which, nine were males with a mean age of 33 years old. Furthermore, nine out of the twelve cases occurred as a result of accidents at work. The mean time elapsed between the lifting of the flap, closure of the donor area, and fixation of the flap to the affected area was 56 minutes (44-72 minutes). In the immediate postoperative period, three patients presented signs of infection in the surgical area. No total dehiscence, total necrosis, and/or hematoma were reported in all patients. The success limb salvage rate was 100%. In our experience, the McGregor inguinal flap technique presented a favorable postoperative evolution with complete closure of the lesions and a low rate of complications. Due to the limitations of this study, more studies are needed to prospectively evaluate this flap.
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Affiliation(s)
- Fernando Rubio-Gallegos
- Department of Reconstructive Plastic Surgery and Burns, Specialist Hospital Eugenio EspejoQuito, Ecuador
| | - Solange Núñez-González
- Center for Research in Public Health and Clinical Epidemiology (CISPEC), University UTEQuito, Ecuador
| | - Christopher Gault
- Center for Research in Public Health and Clinical Epidemiology (CISPEC), University UTEQuito, Ecuador
| | - Daniel Simancas-Racines
- Center for Research in Public Health and Clinical Epidemiology (CISPEC), University UTEQuito, Ecuador
| | - Eduardo Basantes-García
- Department of Reconstructive Plastic Surgery and Burns, Specialist Hospital Eugenio EspejoQuito, Ecuador
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Gatea AA, Niazi SM, Pakzad R, Mohammadi M, Abdullah MA. Epidemiological, demographic and outcomes of burns among females at reproductive age in Baghdad/Iraq. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2019; 9:41-48. [PMID: 31149391 PMCID: PMC6526378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 01/16/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Burns remained a major health problem in most developing countries which have increased the mortality and morbidity among the people. This study aimed to describe the epidemiology and outcomes of burn among females at reproductive age and investigate the factors that associated with mortality during the study period in in Baghdad/Iraq. METHODS A retrospective cohort study was undertaken at Al-Karama academic Hospital in Baghdad. Four hundred and thirty-seven females were admitted to this center from 1st of January 2017 to the end of October 2018. Data were collected from the records and patient file at the department of statistics. The information was including the age, education, marital status, occupation, TBSA, degree of burn, length of stay in hospital, causes, and patient condition. Software of STATA version 13 was used to analysis this data. RESULTS The mean age was 27.1 and SD 0.34 with 95% CI (26.4358 to 27.8067). the fire 64.8% (283/437) were the most cause of burn among females. Housewives 65% (284/437) were more probably exposed to burn than others with the mechanism of burning and females with primary education 42.8% (187/437) were more probability of burn than others group. Regard to length of stay, the mean was 7 days and the 95% CI [6.489-7.629]. Thus, 79.2% (346/437) of females that stayed in the hospital for less than 10 days had higher percentage of burn comparing with another period. Mean and SE of TBSA was 57.8 and 1.2 with the 95% CI [55.4051-60.2516]. A significant relationship was found between occupation, education status, TBSA, length of stay, causes of burn and outcomes at the p. value <0.05. The time at risk was 3085 with the incidence rate. 14. The survivor function in one day (Kaplan Meier estimate) was 0.8970 and SE 0.0144 with 95% CI [0.8645-0.9221]. CONCLUSION The patients at age 26-45 years have equal hazard ratio of death (HR=1) at all the times of follow-upping. There is not statistically significant have been found at the (p. value =0.486), the 95% CI for the HR includes the null value of 1. As well the causes of burn, the patients with fire cause have a higher hazard of death HR=1.1 with the (p. value =0.012). Half of cases were single. A significant relationship has been found between the marital status and the age groups of the p. value 0.000. Also, a significant result of the intent status with causes of burn at the p. value 0.000.
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Affiliation(s)
- Abeer Abed Gatea
- Department of Epidemiology and Biostatistics, School of Public Health, International Campus Tehran University of Medical SciencesTehran, Iran
| | | | - Reza Pakzad
- PhD Candidate of Epidemiology, School of Public Health, Tehran University of Medical SciencesTehran, Iran
| | - Mohsen Mohammadi
- MSc Student of Epidemiology, School of Public Health, Tehran University of Medical SciencesTehran, Iran
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Sarbazi E, Yousefi M, Khami B, Ettekal-Nafs R, Babazadeh T, Gaffari-fam S. Epidemiology and the survival rate of burn-related injuries in Iran: a registry-based study. ANNALS OF BURNS AND FIRE DISASTERS 2019; 32:3-9. [PMID: 31285727 PMCID: PMC6588330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/16/2019] [Indexed: 06/09/2023]
Abstract
Burns are considered an important preventable fraction of injuries in low and middle-income countries, and are still a leading cause of death in Iran. This study investigates features of burns in Sina Hospital's Burn Centre in East Azerbaijan Province in order to calculate survival and mortality rates as well as factors affecting mortality in this centre. In this cross-sectional study, demographic characteristics of patients such as age, sex, cause of burns, type of burns, length of stay (LOS) in the hospital, total body surface area (TBSA), anatomic distribution of burn, mortality rate and final status of patients at the time of discharge from hospital (recovery, death) were investigated. The total mortality rate was 6.84%. Hot liquid burns and gas cylinder explosion burns were among the most common. Burns on multiple regions of the body (45.9%) and pelvic and lower limb burns (22%) constituted the next most common injury. In the TBSA index, compared to reference categories (extent of burn less than 50 percent), the categories of 50-59, 60-69, 70-79, 80-89 and over 90 percent indicated lowest survival based on the Log-Rank test. Hazard ratio for burns greater than 10% was 15.33 fold. Total body surface area burned of over 10% constantly increases the instantaneous risk of mortality therefore there is a need to enhance the quality of care provided to burn victims.
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Affiliation(s)
- E. Sarbazi
- Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M. Yousefi
- Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - B. Khami
- Urmia University of Medical Sciences, Urmia, Iran
| | - R. Ettekal-Nafs
- Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - S. Gaffari-fam
- Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Srivastava S, Kumari H, Singh A, Rai R. Electrical burn injury: a comparison of outcomes of high voltage versus low voltage injury in an Indian scenario. ANNALS OF BURNS AND FIRE DISASTERS 2018; 31:174-177. [PMID: 30863247 PMCID: PMC6367854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/19/2018] [Indexed: 06/09/2023]
Abstract
Electrical burn injury (EBI) is a mutilating form of injury. The objective of this study was to evaluate the various aspects of EBI and analyse the differences between high voltage injury (HVI) and low voltage injury (LVI). A retrospective study was conducted by reviewing the medical records of all burn admissions from June 2016 to May 2017. A total of 1572 patients were admitted, of which 385 (24.49%) had suffered an electrical injury. 104 (27.01%) patients sustained LVI and 281 (72.98%) HVI. One hundred patients from both groups were randomly selected using the chit method, in order to analyse their differences. In our study, the mean age was 35.23±19.96 in the HVI group and 24.15±14.39 years in the LVI group. Most of the injuries were work related. Events during the early phase of admission included a rise in serum creatine phosphokinases, myoglobinuria, renal failure, abnormal cardiac events and other concomitant injuries in the HVI group (p<0.001). Unfavourable outcomes in the form of amputations, prolonged hospital stay and high mortality rate were observed in the HVI group (8.5%) (p<0.027). However, LVI cannot be overlooked as number of reconstructive surgeries and mean number of operations showed no significant difference between both groups. HVI has a disastrous impact on burn survivors but LVI cannot be underestimated. We advocate a low threshold for managing associated injuries, education on safety principles, for men at work especially, and infrastructure improvement by the state to bring changes to the present scenario.
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Affiliation(s)
- S. Srivastava
- Department of Plastic Surgery, Sawai Man Singh Medical College and Hospital, Rajasthan, India
| | - H. Kumari
- University of Health Sciences, Jaipur, India
| | - A. Singh
- University of Health Sciences, Jaipur, India
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Sadeghian F, Saeedi Moghaddam S, Saadat S, Niloofar P, Rezaei N, Amirzade-Iranaq MH, Mehdipour P, Abbaszadeh Kasbi A, Ghodsi Z, Mansouri A, Sharif-Alhoseini M, Jazayeri SB, Aryannejad A, Ehyaee V, Naghdi K, Derakhshan P, Moradi-Lakeh M, Mokdad AH, O'Reilly G, Rahimi-Movaghar V. The trend of burn mortality in Iran - A study of fire, heat and hot substance-related fatal injuries from 1990 to 2015. Burns 2018; 45:228-240. [PMID: 30274812 DOI: 10.1016/j.burns.2018.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/30/2018] [Accepted: 09/05/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Burn injuries are a major cause of preventable mortality worldwide. To implement preventive strategies, a detailed understanding of the rate and trend of fatal burn injuries is needed. The aim of this study was to determine the rate and trend of burn mortality at national and province level in Iran from 1990 to 2015. MATERIALS AND METHODS The data were retrieved from various sources: the Death Registration System, cemetery databases, the Demographic and Health Survey and three national population and housing censuses. ICD-10 codes were converted to Global Burden of Disease (GBD) codes for comparability. After addressing the incompleteness of death data, statistical methods such as spatio-temporal modelling and Gaussian Process Regression (GPR) were applied to estimate the levels and trend of death and cause specific mortality. RESULTS The number of deaths due to burning across Iran was 80,625, with a male to female ratio of 0.88, 0.94 and 1.14 in 1990, 1995 and 2015, respectively. The annual percentage change of age-standardized death rate from 1990 to 2015 was -5.42% and -4.22% in women and men, respectively. The burn-related age-standardized mortality rate decreased considerably from 5.97 in 1990 to 1.74 per 100,000 in 2015. The mortality rate due to burns was highest among those aged more than 85 years, especially in Ilam province. CONCLUSION This study showed a decline in burn mortality in Iran from 1990 to 2015. Continued efforts to reduce the burden of burns are needed to accelerate this progress and prevent injuries.
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Affiliation(s)
- Farideh Sadeghian
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Saadat
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parastoo Niloofar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Amirzade-Iranaq
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Universal Network of Interdisciplinary Research in Oral and Maxillofacial Surgery (UNIROMS), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Parinaz Mehdipour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Anita Mansouri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Behzad Jazayeri
- Department of Surgery, Kaiser Permanente, Fontana, CA, USA; Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, USA
| | - Armin Aryannejad
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Vida Ehyaee
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Khatereh Naghdi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Derakhshan
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, WA, USA
| | - Gerard O'Reilly
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Lethal area 50 percent (LA50) or standardized mortality ratio (SMR): Which one is more conclusive? Burns 2018; 44:1468-1474. [DOI: 10.1016/j.burns.2018.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/30/2018] [Accepted: 04/05/2018] [Indexed: 11/17/2022]
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Mashreky SR, Shawon RA, Biswas A, Ferdoush J, Unjum A, Rahman AKMF. Changes in burn mortality in Bangladesh: Findings from Bangladesh Health and Injury Survey (BHIS) 2003 and 2016. Burns 2018; 44:1579-1584. [PMID: 29887350 DOI: 10.1016/j.burns.2018.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 12/27/2017] [Accepted: 01/08/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE This paper is focused to reflect the changes in burn mortality and events leading to fatal burn injuries. METHODS Two national community-based cross sectional health and injury surveys were done in Bangladesh during 2003 and 2016. Similar methodology had been followed in both the surveys. Multistage cluster sampling method considering probability-proportional-to-size strategy was used in both the surveys to obtain the desired sample. A pretested semi-structured questionnaire was deployed to identify causes of mortality and morbidity among the population. Verbal autopsy method was used to ascertain the cause of death. RESULTS An estimated 5000 deaths occurred during 2002 due to burn, whereas, around 9000 deaths were caused by burn in 2015 reflected by the death rates 3.5 and 5.7 per 100,000 population in respective years. This study found an increase in death rates in all age groups from 2002 to 2015. Electrocution caused the highest burn deaths in this country, especially among males and in rural areas. The death toll by this particular mechanism has increased by more than two folds within a decade. The place of occurrence of fatal burn injuries has also shifted from home to the outside of the home especially in the agricultural fields. CONCLUSION Burn death is an emerging cause of injury deaths in Bangladesh. Further researches are required to explore the epidemiology of electrocution deaths in Bangladesh and design effective interventions.
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Affiliation(s)
- Saidur Rahman Mashreky
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh; Department of Non-Communicable Diseases, Bangladesh University of Health Sciences, Bangladesh.
| | - Riffat Ara Shawon
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh.
| | - Animesh Biswas
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh.
| | - Junnatul Ferdoush
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh.
| | - Afrida Unjum
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh.
| | - A K M Fazlur Rahman
- Centre for Injury Prevention and Research Bangladesh, Dhaka, Bangladesh; Department of Epidemiology, Bangladesh University of Health Sciences, Bangladesh.
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Mirza Aghazadeh A, Lotfi M, Ghahramanian A, Ahadi F. Lethal Area 50 in Patients with Burn Injuries in North West, Iran. J Caring Sci 2018; 7:53-58. [PMID: 29637058 PMCID: PMC5889799 DOI: 10.15171/jcs.2018.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 09/03/2017] [Indexed: 11/09/2022] Open
Abstract
Introduction: In view of their considerably high rates of mortality and morbidity, burns are still viewed as one of the most important health-threatening environmental hazards imposing a significant burden on the health care system in low and middle-income countries. This study seeks to determine the lethal area fifty percent (LA50) in all burn patients admitted over a period of five years and the factors influencing mortality in burn injuries. Methods: This study was a cross-sectional carried out from 2010 to 2014 in Sina Hospital of Tabriz, 1226 participant including 319 women, 346 men, 272 girls, and 289 boys were selected through stratified sampling. The demographic and clinical data of patients ( their age, gender, burn type, TBSA, the season and consequences of burning) were all extracted and then analyzed, using descriptive statistics (measures of central tendency and variability) and inferential statistics(chi-square and linear regression)at a significance level of 0.05. The LA50 was calculated through determining the relationship between the total body surface area and mortality rate (The extent of the body burns measured and recorded based on Lando Chart in hospitals). Results: The highest (47.6%) and the lowest (3.8%) rates of burns were observed among those aged below 16 and above 65, respectively. The majority of the participants were residents of cities (55.4%), married (34.6%), illiterate (56.6%), and housewives (14.8%). Most burns were caused by accidents (98.4%) at home (90.6%). Most patients had suffered first- and second-degree burns (68.4%), with no inhalation damages (99.5%). Hot liquids were the main culprit in most of the burns (58.7%) and the upper extremities were the most frequently affected areas (34.8%). There was .99 rise in mortality for every percent increase in TBSA, and there seemed to be a significant relationship between the age level and the eventual outcome- the higher the age, the more likely for the incident to end in death.LA50 was also determined 43.73 percent for five years. Finally, the study findings showed that female gender, TBSA and age are associated with death from burn. Conclusion: Given the high LA50 index at this center, it is of high priority in our country to enhance the public knowledge and the quality of the care provided for the burn patients. Patients at risk including women, children, elderly and extensive burns should be considered.
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Affiliation(s)
- Ahmad Mirza Aghazadeh
- Department of Basic Sciences, Paramedical Faculty, Tabriz University of Medial Sciences, Tabriz, Iran
| | - Mojgan Lotfi
- Department of Medical-Surgical, Nursing and Midwifery Faculty, Tabriz University of Medial Sciences, Tabriz, Iran
| | - Akram Ghahramanian
- Department of Medical-Surgical, Nursing and Midwifery Faculty, Tabriz University of Medial Sciences, Tabriz, Iran
| | - Farideh Ahadi
- Department of Medical-Surgical, Nursing and Midwifery Faculty, Tabriz University of Medial Sciences, Tabriz, Iran
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Navarrete N. Hyperkalemia in electrical burns: A retrospective study in Colombia. Burns 2018; 44:941-946. [PMID: 29395406 DOI: 10.1016/j.burns.2017.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 11/30/2017] [Accepted: 12/11/2017] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Classically, hyperkalemia has been regarded as a complication in patients with electrical burns. The etiology of hyperkalemia includes metabolic acidosis, destruction of red blood cells, rhabdomyolysis and the development of renal failure. The purpose of this study was to determine the prevalence of hyperkalemia within the first 24h after electrical burn injury and to evaluate the possible association of serum potassium concentration with cutaneous burn size (%TBSA) and serum creatine phosphokinase (CPK) concentration. METHODS A retrospective, cross-sectional study was conducted, based on review of medical records of adult patients hospitalized in the first 24h post electrical injury. Serum potassium (K+) levels were divided into low, normal, and high groups, with breakpoints at 3.5mmol/L and 5.0mmol/L and normal 3.6-4.9mmol/L. To assess potential differences according to the time elapsed between the time of the injury and the sampling time, data were grouped as follows: t1: samples obtained in the first 6h post-injury; t2: samples taken at 6-12h; t3: samples taken at 12-24h. RESULTS 336 patients were studied. The median age was 32 years old (IQR: 25-43). 95.2% of patients were men. Low and normal values of K+ were observed in 13.7% and 85.1%, respectively. The prevalence of hyperkalemia was only 1.2%, and was not related to previously-administered medications or to simple blood gas pH value during admission. CPK>10,000IU/L was observed in 22.6%. No association was found between the serum potassium concentration and either %TBSA burned or the highest CPK value. CONCLUSIONS First, patients admitted to our burn unit with electrical injury accompanied by significant skin and muscle injury rarely exhibit hyperkalemia. Secondly, the presence of hyperkalemia is independent of the severity of rhabdomyolysis or the extent of the burn.
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Affiliation(s)
- Norberto Navarrete
- Emergency Physician, Clinical Epidemiology, Burn Intensive Care Unit, U.S.S. Simón Bolívar Hospital, Bogotá, Colombia.
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