Effect of early grafting on improvement of lethal area index (la50) in burn patients: a 7-year investigation in a burn referral centre in the North of Iran.

Abstract

Burning is a major health challenge in all societies. In this descriptive cross-sectional study, health information about hospitalized burn patients was extracted from the hospital information system from April 2009 to February 2015. Logistic regression method was used to identify risk factors and mortality predictors. Lethal area index (LA50) was investigated to evaluate the quality of annual hospital medical care. A total of 7725 patient medical files were examined. Mean age of the patients was 32.3±22.5 years old. The most common cause of burning accidents was hot liquids. Mean percentage of total body surface area was 15.8±17.9%. The most and the least common affected areas were upper parts and posterior thorax, respectively. Total calculated LA50 was 56.22 (CI95% = 50.09-62.20). This index was 43.89%, 46.43%, 52.29%, 52.29%, 57.00%, 62.08% and 67.53% annually from 2009 to 2015, respectively. There was a statistically significant difference with regards to mortality rate in the different age groups, higher-degree burns, burn location and burn causes. Analysis of mortality predictors in a model adjusted by age and sex showed that old age (p<0.0001), inhalational injuries (p<0.0001) and burn percentage (P<0.0001) were the three mortality predictors in the multiple logistic regression model. The relationship between early grafting and decreased mortality and increased LA50 was nearly significant in statistical analyses. Burn patient survival rate and annual LA50 had an increasing trend in this hospital. Early grafting surgery seemed to be effective on this trend and decreased mortality risk to a large extent.