Ulus Travma Acil Cerrahi Derg. 2017; 23(3): 223-229 | DOI: 10.5505/tjtes.2016.29166

Factors affecting mortality among victims of electrical burns

Çaðrý Tiryaki¹, Mustafa Celalettin Haksal², Murat Burç Yazýcýoðlu¹, Ali Çiftçi¹, Osman Esen³, Hamdi Taner Turgut¹, Abdullah Yýldýrým⁴, Murat Güven^5
1Department of General Surgery, Kocaeli Derince Training and Research Hospital, Kocaeli-Turkey
²Department of General Surgery, Medipol University Faculty of Medicine, Ýstanbul-Turkey
³Department of Anesthesiology and Reanimation, Kocaeli Derince Training and Research Hospital, Kocaeli-Turkey
⁴Department of Burn Treatment Center, Kocaeli Derince Training and Research Hospital, Kocaeli-Turkey
⁵Department of Plastic and Reconstructive Surgery, Kocaeli Derince Training and Research Hospital, Kocaeli-Turkey

BACKGROUND: The aim of this study was to determine the factors affecting mortality rate among patients with an electrical burn.
METHODS: A total of 115 patients admitted to the emergency department and hospitalized in the Burn Treatment Center or Intensive Care Unit (ICU) due to the electrical burn, were included in the study.
RESULTS: A total of 115 patients (4 female and 111 male) with a mean age of 32.88±12.87 years were included in the study. The mean hospitalization period was 25.03±20.50 days, and the mean total body surface area burned (% TBSA) was 22.83±15.54%. Among those patients, 9 (8.5%) expired, and the remaining 106 were discharged after treatment. In a logistic regression analysis, TBSA >20% (p=0.02, OR: 11.7, CI: 1.38–99.16); ICU requirement (p=0.005, OR: 1.28, CI: 1.08–1.58); erythrocyte transfusion requirement (p=0.02, OR: 12.48, CI: 1.44–107.83); fresh frozen plasma (FFP) requirement (p=0.03, OR: 10.23, CI: 1.18–88.17); albumin requirement (p=0.02, OR: 12.60, CI: 1.44–109.85); admission serum albumin level <3.5 mg/dl (p=0.04, OR: 7.25, CI: 0.82–63.64); and admission hemoglobin level <12 mg/dl (p=0.01, OR: 8.29, CI: 1.57–43.61) were determined as risk factors for mortality in patients with electrical burns.
CONCLUSION: In clinical practice, defining a mortality risk analyzer using these factors may be helpful in the management of patients with electrical burns. Additional, more comprehensive studies are required to define the risk factors for mortality and long-term morbidities in patients with electrical burns.

Keywords: Albumin, burn extent, calcium, electrical burns, hemoglobin, mortality.

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Elektrik yanýklarýnda mortaliteye etki eden faktörler

Çaðrý Tiryaki¹, Mustafa Celalettin Haksal², Murat Burç Yazýcýoðlu¹, Ali Çiftçi¹, Osman Esen³, Hamdi Taner Turgut¹, Abdullah Yýldýrým⁴, Murat Güven^5
1Kocaeli Derince Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Kocaeli
²Medipol Üniversitesi Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Ýstanbul
³Kocaeli Derince Eðitim ve Araþtýrma Hastanesi, Anestezi ve Reanimasyon Kliniði, Kocaeli
⁴Kocaeli Derince Eðitim ve Araþtýrma Hastanesi, Yanýk Tedavi Merkezi, Kocaeli
⁵Kocaeli Derince Eðitim ve Araþtýrma Hastanesi, Plastik ve Rekonstrüktif Cerrahi Kliniði, Kocaeli

AMAÇ: Bu çalýþmanýn amacý elektrik yanýðý olan hastalarda mortalite oranlarýna etki eden faktörleri belirlemektir.
GEREÇ VE YÖNTEM: Elektrik yanýðý nedeniyle Derince Eðitim ve Araþtýrma Hastanesi Acil Servisi’ne kabul edilip yanýk tedavi merkezi veya yoðun bakýma (YB) yatýrýlan 115 hasta çalýþmaya dahil edildi.
BULGULAR: Ortalama yaþý 32.88±12.87 yýl olan toplam 115 hastanýn (4 kadýn, 111 erkek) çalýþmaya alýndý. Ortalama hastanede yatýþ süresi 25.03±20.50 gün ve yanan ortalama toplam vücut yüzey alaný (%TVYA) ise %22.83±15.54 idi. Bu hastalarýn 106’sý tedavi sonrasý taburcu edilirken, dokuzu (%8.5) hayatýný kaybetti. Lojistik regresyon analizinde, TVYA >%20 (p=0.02, odds ratio (OR): 11.7, confidence interval (CI): 1.38–99.16), YB gerekenler (p=0.005, OR: 1.28, CI: 1.08–1.58); eritrosit transferi gerekenler (p=0.02, OR: 12.48, CI: 1.44–107.83); Taze donmuþ plazma (TDP) gereksinimi olanlar (p=0.03, OR 10.23, CI: 1.18–88.17); albümin gereksinimi olanlar (p=0.02, OR: 12.60, CI: 1.44–109.85); kabulde serum albümin seviyesi <3.5 mg/dL (p=0.04, OR: 7.25, CI: 0.82–63.64); kabul hemoglobin seviyesi <12 mg/dL (p=0.01, OR: 8.29, CI: 1.57–43.61) hastalarda mortaliteyi belirleyen risk faktörleri olarak belirledik.
TARTIÞMA: Klinik uygulamada, elektrik yanýðý olan hastalarda bu faktörlerin analiz edilmesi mortalite oranýný belirlemede yararlý olabilir. Elektrik yanýðý olan hastalarda mortalite risk faktörlerini ve uzun dönem morbiditeleri belirlemek için daha geniþ çalýþmalara gereksinimi vardýr.

Anahtar Kelimeler: Albümin, elektrik yanýðý, hemoglobin, kalsiyum, mortalite, yanýk derecesi.

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