Revised estimates of mortality from burns in the last 20 years at the Birmingham Burns Centre.

The Birmingham Burns Centre has been regularly presenting its mortality estimates since its pioneering work in 1949 on the use of probit analysis. The last of these estimates that showed a significant improvement in survival was presented in 1971. This improvement was attributed to the introduction of topical 0.5% silver nitrate against Pseudomonas aeruginosa. In the last 20 years, several changes in management of burns have taken place following a better knowledge of its pathophysiology. This study shows our experience from the last 20 years by comparing mortality estimates between two successive 10-year periods i.e., 1979-1988 and 1989-1998. We used probit analysis for deriving lethal area 50 (LA 50) for various age groups. The comparison showed that the mortality curves between the two periods were identical suggesting no improvement in the chances of survival. Since the mortalities were so similar the data were combined. The LA 50s derived from this combined data when compared with our earlier series from 1965 to 1970 also did not show a significant change in mortality. We conclude that in our experience the chances of dying for a given severity of injury have not changed significantly for more than 20 years.