Mortality evolution study of burn patients in a critical care burn unit between 1971 and 1991.

This study was carried out in the critical care area of a burn unit. The mortality of burn patients was studied over three periods: 1971-83; 1984-87; 1988-91. The first period was studied retrospectively, the more recent periods were studied prospectively. The number of patients included in the study was 2859. The incidence of fatal burns during the three periods was compared standardizing for age, body burn surface and burn depth. Taking the first period as a reference, the mortality reduction in the second and third period was 14 and 37 per cent, respectively. In both the more recent periods of intensive medical care was introduced for the patients; early surgical treatments; nasal, pharyngeal, intestinal and burn surface decolonization and catheter puncture prophylaxis. We believe that the observed mortality reduction was due to these reasons. Using logistic regression a predictive mortality equation was obtained with three risk factors: age, total body surface area burned and burn depth. We are now able to obtain a mortality score soon after the patient is admitted to the unit.