Burns最新文献

{"title":"Effect of fluid resuscitation with albumin on mortality in patients with severe burns: A nationwide inpatient data analysis","authors":"Kazuha Nakamura, Toshiaki Isogai, Hiroyuki Ohbe, Mikio Nakajima, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga","doi":"10.1016/j.burns.2024.07.031","DOIUrl":"https://doi.org/10.1016/j.burns.2024.07.031","url":null,"abstract":"The present study aimed to evaluate the effect of albumin administration on mortality in patients with severe burns. We retrospectively analyzed data from the Diagnosis Procedure Combination Database, a nationwide inpatient database in Japan. We identified patients in the database aged ≥ 15 years who were admitted with severe burns (burn index ≥15) from April 2014 to March 2021. We included patients who received albumin within 2 days of admission in the albumin group and those who did not in the control group. The outcome was the 28-day mortality. Eligible patients (n = 2492) were categorized into an albumin group (n = 1128) or a control group (n = 1364). One-to-one propensity score matching generated 530 pairs of patients with and without albumin administration. The 28-day mortality did not differ significantly between the two groups (albumin vs. control, 21.7 % vs. 22.8 %; risk difference, −1.1 %; 95 % confidence interval, −6.1 % to +3.9 %). These results suggest that albumin administration within 2 days of admission in patients with severe burns may not be associated with mortality during the acute phase.","PeriodicalId":50717,"journal":{"name":"Burns","volume":"11 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141946055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healing mechanism of cotton bandage loaded with PNIPAM/GO-Ag hydrogel on the deep second-degree burn wound in rats model","authors":"Ning Liu, Baoxia Xue, Wei Cheng, Yong Liu, Mei Niu, Yongzhen Yang, Shiping Yu, Li Zhang","doi":"10.1016/j.burns.2024.08.001","DOIUrl":"https://doi.org/10.1016/j.burns.2024.08.001","url":null,"abstract":"Dressings play a crucial role in the management of burn wound. In this study, the cotton bandage was modified with the Poly (N-isopropylacrylamide) / graphite oxide/nano silver (PNIPAM/GO-Ag) hydrogel to obtain a novel dressing (PNIPAM/GO-Ag/COT). The healing effect of the PNIPAM/GO-Ag/COT dressing on deep second-degree burn wounds in rats and the changes of related inflammatory factors were explored and analyzed systematically. The deep second-degree burn model was established by the steam scald method in Sprague–Dawley (SD) rats. The granulation tissue, collagen deposition, the expressions of tumor necrosis factor-α (TNF-α), and basic fibroblast growth factor (bFGF) of the wound were evaluated by means of the HE staining, Masson staining, ELISA, and immunohistochemistry methods. The results showed that, compared with the blank group (rats without the dressing treatment), the PNIPAM/GO-Ag/COT dressing reduced the expression of TNF-α by approximately 18 % and promoted the bFGF expression in wound tissue. Compared to the control group (rats with the gauze treatment), the wound healing rate in the PNIPAM/GO-Ag/COT dressing group was 58 % on the 14th day, with an increase of 30 %. These results demonstrated that the PNIPAM/GO-Ag/COT dressing primarily promoted burn wound healing by reducing inflammatory reactions, promoting collagen deposition, and enhancing the expression of bFGF.","PeriodicalId":50717,"journal":{"name":"Burns","volume":"373 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141946053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the underlying mechanism by transcriptome sequencing in rats with high-voltage electrical burns and the role of iron metabolism","authors":"Jiawen Hao, Mengyuan Lu, Xuegang Zhao, Congying Li, Chenyang Ge, Jing Zhang, Lihong Tu, Qingfu Zhang","doi":"10.1016/j.burns.2024.07.030","DOIUrl":"https://doi.org/10.1016/j.burns.2024.07.030","url":null,"abstract":"Clinically, the condition of skeletal muscle injury is the key to the process of high voltage electrical burn (HVEB) wound repair. The aim of this study was to identify the potential mechanisms and intervention targets of skeletal muscle injury after HVEB. A skeletal muscle injury model in SD rats with HVEB was made. Pathological examination and transcriptome sequencing of injured skeletal muscles were performed, and the expression levels of key proteins and genes in related signaling pathways were verified. Skeletal muscle injury was progressively aggravated within 48 h, then the injury was gradually repaired with scar formation occurring within 1 week. The mechanism of skeletal muscle injury is complex and varied, and ferroptosis is one of the mechanisms. The ferrous iron content in the injured skeletal muscle tissue of model rats increased significantly at 24 h after injury. After 24 h, damage to injured skeletal muscle tissue could be alleviated by increasing iron storage and blocking lysosomal phagocytosis of autophagy. Skeletal muscle injury caused by HVEB is characterized by progressive progression after injury. Ferroptosis is involved in the mechanism of HVEB, and iron metabolism-related proteins may be potential targets for preventing progressive skeletal muscle injury.","PeriodicalId":50717,"journal":{"name":"Burns","volume":"12 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141946056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of subdermal adipose derived stem cell injections and early excision on systemic oxidative stress and wound healing in rats with severe scald burns","authors":"Kubilay Gürünlüoğlu , Basri Satilmiş , Mehmet Gül , Muhammed Dündar , Nurcan Göktürk , Sami Akbulut , Ahmet Koç , Semra Gürünlüoğlu , Mehmet Aslan , Ezgi Karaaslan , Mehmet Akif Türköz , Çağla Güner Toplu , Hasan Ateş , Muhammed Mehdi Üremiş , İrem Nur Menevşe , Elif Kayhan Kuştepe , Seren Sari Ünal , Ebubekir Altundaş , Turan Yildiz , Tevfik Tolga Şahin , Mehmet Demircan","doi":"10.1016/j.burns.2024.07.037","DOIUrl":"10.1016/j.burns.2024.07.037","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to develop an experimental treatment model effective against oxidative stress in the acute period of severe burns and to analyze the mechanisms of healing large wound defects.</div></div><div><h3>Methods</h3><div>Five rats, including 2 females and 3 males, were used as donors to obtain adipose-derived stem cells (ADSC) from the inguinal fat pad. The stem cells were labeled with green fluorescent protein. The study included four groups of 17 rats, each with grade 3 scalding burns on 30 % of their body surface, and a control group of 10 rats with an equal number of males and females. After early excision, 10<sup>6</sup> ADSC-derived stem cells were administered subdermally to the burned wound and autografted to the stem cell group (n = 17). The early excision group (n = 17) received early excision and autograft, with 2 ml of normal saline injected subdermally into the burn wound edge. The PLM group (n = 17) was treated with a polylactic membrane (PLM) dressing after the burn. No treatment was given to the burn group (n = 17). Ten rats from all groups were sacrificed on the 4th day post-burn for oxidative stress evaluation. The control group (n = 10) was sacrificed on day 4. Blood and tissue samples were collected post-sacrifice. Oxidative stress and inflammation in the blood, as well as cell damage in the skin, liver, kidneys, and lungs, were investigated histopathologically and biochemically on the 4th day post-burn. On the 70th day after burn, wound healing was examined macroscopically and histopathologically.</div></div><div><h3>Results</h3><div>On the 4th day, oxidative stress results showed that the levels of Total Oxidative Capacity (TOC) in the blood were lowest in the stem cell (7.4 [6–8.8]), control (6.7 [5.9–7.6]), and early excision (7.5 [6.6–8.5]) groups, with no significant difference between them. The burn group (14.7 [12.5–16.9]) had the highest TOC levels. The PLM group (9.7 [8.6–10.7]) had lower TOC levels than the burn group but higher levels than the other groups.</div><div>Histopathological examination on the 4th day revealed low liver caspase-3 immunoreactivity in the stem cell and early excision groups among the burn groups. Caspase-3 immunoreactivity levels were as follows: stem cell group (20 [10–30]), early excision group (25 [15–50]), PLM group (70 [50–100]), control group (0), and burn group (80 [60–120]). Other oxidative stress and end-organ damage outcomes were consistent with these results.</div><div>All rats in the stem cell group had burn wounds that healed completely by the 70th day. Examination of the skin and its appendages from the stem cell group with an immunofluorescence microscope demonstrated green coloration, indicating incorporation of stem cells.</div></div><div><h3>Conclusion</h3><div>Stem cells may have the potential to form new skin and its appendages, providing better healing for large skin defects. Early excision treatment, by removing local necrotic tissues afte","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 8","pages":"Pages 2056-2069"},"PeriodicalIF":3.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swallowing impairment in older persons following burn injury: Validation of incidence and predictive factors for dysphagia","authors":"Nicola A. Clayton ,&nbsp;Caroline M. Nicholls ,&nbsp;Cheryl Brownlow ,&nbsp;Justine O’Hara ,&nbsp;Andrea C. Issler-Fisher ,&nbsp;Oliver M. Fisher ,&nbsp;Peter K. Maitz","doi":"10.1016/j.burns.2024.07.032","DOIUrl":"10.1016/j.burns.2024.07.032","url":null,"abstract":"<div><h3>Background</h3><div>Early retrospective data identify that dysphagia is common in older persons with burn injury, suggesting a rate of 47 %, and that it is associated with medical, burn, and nutritional outcomes.</div></div><div><h3>Aims</h3><div>To prospectively (1) explore the incidence, (2) describe associations, and (3) evaluate risk factors for dysphagia in patients ≥ 75 years old hospitalised with burn injury.</div></div><div><h3>Methods</h3><div>All patients &gt; 75 years old admitted to Concord-Repatriation-General-Hospital with burn injury over 4 years (2019–2023) were assessed for dysphagia on presentation and were continually monitored throughout their admission. Burn injury, demographic, and nutritional data were prospectively captured and analysed for association with dysphagia.</div></div><div><h3>Results</h3><div>Sixty-two patients (33 male) aged 75–95 years (median=83 years) were recruited. Dysphagia was identified in 50 %. Dysphagia was associated with burn size (p = 0.002), pre-existing cognitive impairment (p = 0.000), hospital length of stay (p = 0.001), in-hospital complications (p = 0.000), feeding dependence (p = 0.002), nutritional status (p = 0.013) and enteral feeding duration (p = 0.030). Cognitive impairment was the most sensitive predictor for dysphagia at 100 % (specificity=29 %, NPV=100 %, PPV=59 %). Development of secondary comorbidities was less sensitive at 52 % (NPV 65 %), but was associated with high specificity (90 %) and PPV (84 %).</div></div><div><h3>Conclusions</h3><div>One in every two patients ≥ 75 years admitted with burn injury will demonstrate dysphagia during their hospital admission. Those with pre-existing cognitive impairment are most at risk.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 8","pages":"Pages 2084-2090"},"PeriodicalIF":3.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed admission to hospital with proper prehospital treatments prevents severely burned patients from sepsis in China: A retrospective study","authors":"Runzhi Huang ,&nbsp;Yuanan Li ,&nbsp;Shuyuan Xian ,&nbsp;Wei Zhang ,&nbsp;Yifan Liu ,&nbsp;Sujie Xie ,&nbsp;Dayuan Xu ,&nbsp;Yushu Zhu ,&nbsp;Hanlin Sun ,&nbsp;Jiale Yan ,&nbsp;Xinya Guo ,&nbsp;Yixu Li ,&nbsp;Jianyu Lu ,&nbsp;Xirui Tong ,&nbsp;Yuntao Yao ,&nbsp;Weijin Qian ,&nbsp;Bingnan Lu ,&nbsp;Jiaying Shi ,&nbsp;Xiaoyi Ding ,&nbsp;Junqiang Li ,&nbsp;Shizhao Ji","doi":"10.1016/j.burns.2024.07.029","DOIUrl":"10.1016/j.burns.2024.07.029","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is one of the major causes of morbidity and mortality in burn patients. However, the optimal timing of admission which can minimize the probability of sepsis is still unclear. This study aims to determine the optimal time period of admission for severely burned patients and find out the possible reasons for it.</div></div><div><h3>Method</h3><div>185 victims to the Kunshan factory aluminum dust explosion accident, which happened on August 2nd, 2014, were studied. The optimal cutpoint for continuous variables in survival models was determined by means of the maximally selected rank statistic. Univariate and multivariate analyses were further conducted to verify that admission time was not a risk factor for sepsis. Subgroup analyses were performed to find out possible contributing factors for the result.</div></div><div><h3>Result</h3><div>The cutoff point for admission time was determined as seven hours, which was supported by the survival curve (p &lt; 0.001). Multivariate analysis showed that, in our study population, delayed admission time was not a risk factor for sepsis (HR = 0.610, 95 %CI = 0.415 - 0.896, <em>p</em> = 0.012). Subgroup analyses showed that “Tracheotomy before admission” (<em>p</em> = 0.002), “Whole blood transfusion” (<em>p</em> &lt; 0.001), “Hemodynamic instability before admission” (<em>p</em> = 0.02), “Has a burn department in the hospital” (<em>p</em> = 0.009), “Has a burn ICU in the hospital” (<em>p</em> &lt; 0.001), “Acute heart failure (AHF)” (<em>p</em> = 0.05), “acute respiratory distress syndrome (ARDS)” (<em>p</em> = 0.05) and “GI bleeding” (<em>p</em> = 0.04) were all statistically significant.</div></div><div><h3>Conclusion</h3><div>In our study population, we found that delayed admission time was not a risk factor associated with a reduced incidence of sepsis among severely burned patients. This might be attributed to variations in prehospital treatments (whole blood transfusion and tracheotomy), whether the hospital had a burn department/ICU, and certain complications (AHF, ARDS and GI bleeding). It can be inferred that early prehospital care plays a crucial role in reducing sepsis risk among severe burn patients.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 8","pages":"Pages 1977-1990"},"PeriodicalIF":3.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141945916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the impact of patient-centered peer counseling on anxiety and pain among burn patients: A randomized controlled trial","authors":"Mohammad Rahimkhani ,&nbsp;Ali Mohammadabadi ,&nbsp;Mohammadreza Askari ,&nbsp;Masoud Abdollahi","doi":"10.1016/j.burns.2024.07.034","DOIUrl":"10.1016/j.burns.2024.07.034","url":null,"abstract":"<div><h3>Objective</h3><div>Pain and anxiety are common complications in burn patients, significantly impacting treatment effectiveness and overall patient well-being. Peer counseling, a form of patient education provided by individuals with shared experiences, may hold potential to alleviate this pain and anxiety. This study seeks to investigate the effectiveness of patient-centered education through peer counseling on background pain and state anxiety levels in these patients.</div></div><div><h3>Methods</h3><div>A two-arm, parallel, randomized, controlled trial design was employed. A total of 86 participants were randomly allocated to one of two groups: control and intervention groups. State anxiety and background pain levels were assessed using the Spielberger State Anxiety Inventory (STAI) and Visual Analogue Scale (VAS), respectively, before and after intervention. Statistical analyses, including Chi-square test, Fisher's exact test, independent t-test, and paired t-test, were employed to analyze the data.</div></div><div><h3>Results</h3><div>The intervention significantly reduced pain and anxiety in the intervention group compared to baseline (p &lt; .001). There was no significant difference between the control and intervention groups in baseline levels, but there was a significant difference after the intervention (p &lt; .001).</div></div><div><h3>Conclusion</h3><div>This study demonstrates the efficacy of patient-centered education through peer counseling in reducing background pain and state anxiety levels in burn patients. Compared to standard education, peer counseling led to a more pronounced reduction in both pain and anxiety, suggesting its potential as a valuable nonpharmaceutical intervention to improve patient well-being during burn recovery.</div></div><div><h3>Practice implications</h3><div>Based on our findings, we recommend that healthcare providers consider implementing peer-based education programs in burn care settings.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 8","pages":"Pages 2091-2102"},"PeriodicalIF":3.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promising anti-inflammatory activity of a novel designed anti-microbial peptide for wound healing","authors":"Fariba Fathi ,&nbsp;Maryam Ghobeh ,&nbsp;Farshad H. Shirazi ,&nbsp;Maryam Tabarzad","doi":"10.1016/j.burns.2024.07.036","DOIUrl":"10.1016/j.burns.2024.07.036","url":null,"abstract":"<div><div>Chronic wounds can develop as a result of prolonged inflammation during the healing process, which can happen due to bacterial infection. Therefore, preventing infection and controlling inflammation can accelerate wound healing. Antimicrobial peptides have different protective properties in addition to antimicrobial activity. Some of these activities include the stimulation of cytokine or chemokine synthesis, the facilitation of chemotaxis and cell proliferation, the acceleration of cell proliferation, the induction of anti-inflammatory responses, and the promotion of wound repair. This study aimed to assess the wound healing potential of a novel in silico-designed antimicrobial peptide. Then, its anti-inflammatory activity was investigated by measuring the level of tumor necrosis factor-α (TNF-α) and transforming growth factor beta (TGF-β) as indicators of the wound healing process. In addition, the influence of the peptide on cell migration was evaluated by a scratch test on human dermal fibroblasts (HDF) and HaCaT cells as a human epidermal keratinocyte cell line. The results showed that our new peptide could act well in inhibiting TNF-α over-secretion while increasing the expression of TGF-β as an anti-inflammatory factor. This peptide showed a significant potential to stimulate HDF and HaCaT cell migration and proliferation. Therefore, using this peptide as an anti-inflammatory component of wound dressings may be promising.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 8","pages":"Pages 2045-2055"},"PeriodicalIF":3.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141969417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical appraisal of the “one-day-per-percent” rule - A register-based observational study","authors":"RL Brekke ,&nbsp;SK Almeland ,&nbsp;KO Hufthammer ,&nbsp;AB Guttormsen ,&nbsp;E. Hansson ,&nbsp;H. Onarheim","doi":"10.1016/j.burns.2024.07.033","DOIUrl":"10.1016/j.burns.2024.07.033","url":null,"abstract":"<div><h3>Background</h3><div>The ”one-day-per-percent” rule states that for burn patients, one day of hospital stay can be expected for each percentage of burned body surface. This study aimed to test the rule's predictive value.</div></div><div><h3>Methods</h3><div>The study is a register-based observational study on all burns treated in the Norwegian National Burn Center 2000–22. All children and adults admitted and actively treated in this period were included (2269 patients). Patients receiving palliative care were not included (55). Age when injured, sex, year of admittance, LOS (length of stay), %TBSA (total body surface area), discharged alive/dead, and palliative care: yes/no were extracted from the registry. Quantile regression was used to estimate the quantiles of LOS/%TBSA as a function of %TBSA.</div></div><div><h3>Results</h3><div>For injuries &lt; 15 %TBSA, the median LOS/%TBSA values were above 1.0, and the ratio increased as the injury size decreased. The median LOS/%TBSA values were close to 1.0 for patients with injuries ≥ 15 %TBSA (Table 2, Figure 2). The quantile regression analysis revealed a considerable spread in estimated values for both adults and children. Children had a lower median LOS/%TBSA than adults and a value below 1.0 for injuries 15–30 %TBSA. When survivors and non-survivors were compared, a higher median LOS/%TBSA was found for survivors with injuries &gt; 60 %TBSA.</div></div><div><h3>Discussion</h3><div>The ”one-day-per-percent” rule does not seem applicable for injuries &lt; 15 %TBSA. Even for more extensive injuries, the large spread in estimated values in different quantiles renders it poor at predicting length of hospital stay. There also seem to be many caveats when it is used to measure an institution's efficacy or when comparing different institutions.</div></div><div><h3>Conclusion</h3><div>The predictive value of the “one-day-per-percent” rule is deficient when considering individual patients. It does not fit for injuries &lt; 15 %TBSA, and the significant variation for patients with injuries of a similar extent renders it not viable as a forecasting tool.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 8","pages":"Pages 1991-1998"},"PeriodicalIF":3.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative sum (CUSUM) analysis: A 10 year experience of outcome monitoring in a regional burn centre","authors":"Sofia Eriksson ,&nbsp;Niall Martin ,&nbsp;Sarah Smailes ,&nbsp;Peter Dziewulski","doi":"10.1016/j.burns.2024.07.035","DOIUrl":"10.1016/j.burns.2024.07.035","url":null,"abstract":"<div><h3>Introduction</h3><div>Outcome monitoring can identify fluctuations in healthcare. Cumulative sum (CUSUM) analysis can detect when mortality deviates from expected, allowing early intervention through targeted audit. We present a 10-year experience of the prospective use of CUSUM methodology in a regional burn centre.</div></div><div><h3>Method</h3><div>Prospective outcome monitoring was conducted for all admissions to the intensive care unit between 2012 and 2022. The revised Baux score was used for mortality risk prediction. Risk-adjusted CUSUM charts tracked mortality against that predicted by the revised Baux score. Deviations from expected outcomes triggered detailed structured analysis. Learning outcomes were identified from internal and external governance groups.</div></div><div><h3>Results</h3><div>CUSUM analysis was triggered on eight occasions: one paediatric (excess deaths), six adult (four excess survivors, two excess deaths) and one elderly (excess survivors). Detailed analysis identified areas for continuous improvement and positive themes from excess survivors.</div></div><div><h3>Conclusion</h3><div>The use of CUSUM as an early warning trigger stimulates assessment of practice and critical appraisal of factors contributing to unexpected mortality or survival. The revised Baux score at its foundation needs to be carefully considered but remains a valid model. One benefit is positive reinforcement of team cohesion and morale during periods of care excellence leading to excess survivors.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"50 8","pages":"Pages 1999-2006"},"PeriodicalIF":3.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}