Severe burn injury in europe: a systematic review of the incidence, etiology, morbidity, and mortality. Critical Care 14:R188

Department of General Internal Medicine, Infectious Diseases and Psychosomatic Medicine, Ghent University Hospital, De Pintelaan 185, Ghent 9000, Belgium.
Critical care (London, England) (Impact Factor: 4.48). 10/2010; 14(5):R188. DOI: 10.1186/cc9300
Source: PubMed


Burn injury is a serious pathology, potentially leading to severe morbidity and significant mortality, but it also has a considerable health-economic impact. The aim of this study was to describe the European hospitalized population with severe burn injury, including the incidence, etiology, risk factors, mortality, and causes of death.
The systematic literature search (1985 to 2009) involved PubMed, the Web of Science, and the search engine Google. The reference lists and the Science Citation Index were used for hand searching (snowballing). Only studies dealing with epidemiologic issues (for example, incidence and outcome) as their major topic, on hospitalized populations with severe burn injury (in secondary and tertiary care) in Europe were included. Language restrictions were set on English, French, and Dutch.
The search led to 76 eligible studies, including more than 186,500 patients in total. The annual incidence of severe burns was 0.2 to 2.9/10,000 inhabitants with a decreasing trend in time. Almost 50% of patients were younger than 16 years, and ~60% were male patients. Flames, scalds, and contact burns were the most prevalent causes in the total population, but in children, scalds clearly dominated. Mortality was usually between 1.4% and 18% and is decreasing in time. Major risk factors for death were older age and a higher total percentage of burned surface area, as well as chronic diseases. (Multi) organ failure and sepsis were the most frequently reported causes of death. The main causes of early death (< 48 hours) were burn shock and inhalation injury.
Despite the lack of a large-scale European registration of burn injury, more epidemiologic information is available about the hospitalized population with severe burn injury than is generally presumed. National and international registration systems nevertheless remain necessary to allow better targeting of prevention campaigns and further improvement of cost-effectiveness in total burn care.

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    • "Following both mild and severe traumatic injury, older adults suffer from an increased incidence and severity of nosocomial infection (Blot et al. 2014;Bochicchio et al. 2001;Butcher et al. 2003;Vanzant et al. 2015), which has adverse effects on outcome in respect of increased mortality rates and longer length of hospital stay (Brusselaers et al. 2010; Colohan2010;Richards et al. 2013). These observations coupled with the future changes that are expected in population demographics (United Nations World Population "
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    ABSTRACT: Compared to younger patients, traumatic injury in older patients is associated with increased mortality and a range of adverse outcomes such as higher rates of infectious episodes, longer length of hospital stay and poor functional outcome at follow up. Data emerging from human and murine-based studies suggest age-related changes in immune function, collectively termed immunesenescence, and the chronic sub-clinical systemic inflammatory state of older adults, termed inflammaging, may contribute to these poor outcomes. Here, we review the findings of these studies, whose results demonstrate that the geriatric trauma patient elicits an immune response to injury that is distinct to that of younger adults, being characterised by reduced immune cell activation, impaired function and abnormal haematopoiesis, defects that are accompanied by an altered inflammatory response that fails to return to a homeostatic baseline in the days following injury. Although considerable evidence is accumulating that demonstrates clear and significant age-related differences in the immune and inflammatory response to traumatic injury, our current understanding of the mechanism(s) that underlie these changes is limited. Future studies that provide a mechanistic explanation for the unique immune and inflammatory response of older adults to traumatic injury are therefore essential if we are to determine whether manipulation of the immune system has potential as a future therapeutic strategy by which to improve the outcome of the geriatric trauma patient.
    Ageing research reviews 10/2015; DOI:10.1016/j.arr.2015.10.003 · 4.94 Impact Factor
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    • "Young children up to four years of age constitute almost 30% of all burn victims in Sweden, and another 10% are children aged five to 14 years (Åkerlund et al., 2007). Similar rates have been observed in other western countries (Brusselaers et al., 2010). Burns are one of the most traumatic and painful injuries a child can experience. "
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    ABSTRACT: A burn is one of the most traumatic and painful injuries a child can experience and it is also a very stressful experience for the parents. Given the great psychological distress and perceived lack of multi-professional support experienced by the parents, there is a need for support during in-hospital treatment as well as during recovery. The aim of the study is to develop and evaluate an internet-based information and self-help program for parents of children who have been hospitalized for burn injury. The program aims to decrease parents' symptoms of stress.
    Internet Interventions 09/2015; 2(4). DOI:10.1016/j.invent.2015.09.003
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    • "Clinically significant inhalational injuries often do not manifest for three to four days after the exposure [16]. Complications of inhalational injury are not uncommon in patients with burns, coma, or other severe unexplained clinical symptoms [3] [17] [18]. There are many cases that are easily missed due to inhalation injury that can occur irrespective of burn injuries severity. "
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    ABSTRACT: Smoke-inhalation injury (SII) is an unfavorable prognostic sign and a major cause of mortality in burn patients. Subsequently, it is important to diagnose early, determine accurately the injuries severity and to intervene early in these patients.
    03/2015; 16. DOI:10.1016/j.ejcdt.2015.03.015
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