Ulus Travma Acil Cerrahi Derg. 2009; 15(6): 599-606

Mortality factors in flame and scalds burns: our experience in 816 patients

Behçet Al¹, Cuma Yýldýrým¹, Sacit Çoban², Mustafa Aldemir³, Cahfer Güloðlu^3
1Department Of Emergency Medicine, Gaziantep University Faculty Of Medicine, Gaziantep, Turkey
²Department Of General Surgery, Medicine Faculty Of Gaziantep University Gaziantepr, Turkey
³Department Of Emergency Medicine Of Gaziantep University Medicine Faculty; Gaziantep, Turkey

BACKGROUND
Our aim was to evaluate the effective factors on mortality in flame and scald burns in the Diyarbakýr region.
METHODS
The data of 816 patients who applied to the Dicle University Emergency Department between January 2001 and May 2005 with flame and scald burns were investigated retrospectively. The patients were separated into two groups as alive or deceased. Gender, age, burns shapes, burn degrees and rates, burn regions, admission periods, hospitalization times, complications, and the treatments were analyzed.
RESULTS
43.5% of the patients were female and 57.5% were male. Six hundred fifty-eight patients were under 6 years old. 70.5% of burns occurred as a result of negligence; 76.5% occurred due to scald and 23.5% due to flame. In cases of death, 39 patients were under 10 years old. The mean age was 9.32 years. The average hospitalization period was 10.37 days. The most common complication was wound infection. The mortality rate was 6.1%.
CONCLUSION
The mortality rate was higher among patients who were hospitalized longer than 15 days (p=0.030); whose burns were due to suicide attempt (p=0.002); who used shoe paint on the burn wounds instead of treatment (p=0.000); who had more than 40% second-degree burns (p=0.000) or more than 20% third-degree burns (p=0.000); and among those with acute respiratory failure, compartment syndrome, hypoalbuminemia, and sepsis (p=0.000).

Keywords: Scald and flame burns, hypovolemia; compartment syndrome; mortality; sepsis.

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Alev ve haþlanma yanýklarýnda mortalitede etkili faktörler: 816 hastada deneyimlerimiz

Behçet Al¹, Cuma Yýldýrým¹, Sacit Çoban², Mustafa Aldemir³, Cahfer Güloðlu^3
1Gaziantep Üniversitesi Týp Fakültesi Acil Týp Abd, Gaziantep, Türkiye
²Gaziantep Üniversitesi Týp Fakültesi Genel Cerrahi Ad. Gaziantep, Türkiye
³Dicle Üniverisitesi Týp Fakültesi Acil Týp Ad, Diyarbakýr, Türkiye

AMAÇ
Diyarbakýr bölgesinde meydana gelen alev ve haþlanma yanýklarýnda mortalite üzerine etkili olan faktörler araþtýrýldý.
GEREÇ VE YÖNTEM
Dicle Üniversitesi Týp Fakültesi Acil Týp Kliniði’ne Ocak 2001 ile Mayýs 2005 yýllarý arasýnda haþlanma ve alev yanýklarý nedeni baþvuran 816 hastanýn verileri geriye dönük olarak incelendi. Hastalar yaþayanlar ve ölenler olmak üzere iki gruba ayrýldý. Hastalarda cinsiyet, yaþ, yanma þekilleri, yanýk dereceleri ve yanýk yüzdeleri, yanýk bölgeleri, baþvuru süreleri, yatýþ süreleri, geliþen komplikasyonlar ve yapýlan giriþimler deðerlendirildi.
BULGULAR
Baþvuran hastalarýn %43,5’i kadýn, %57,5’i erkek idi; 658 hasta altý yaþýn altýndaydý. Yanýklarýn %70,5’i ihmal sonucu meydana gelmiþti. Yanýklarýn %76,5’i haþlanma, %23,5’i de aleve baðlý meydana gelmiþti. Ölen hastalarýn 39’u on yaþýn altýnda idi. Tüm hastalarda yaþ ortalamasý 9,32 idi. Tüm hastalarýn ortalama yatýþ süresi 10,37 gün idi. En sýk geliþen komplikasyon yara enfeksiyonu idi. Genel olarak mortalite oraný %6,1 idi.
SONUÇ
On beþ günden uzun yatan hastalarda (p=0,030), intihar nedeni ile yananlarda (p=0,002), yanýk yerine tedavi niyeti ile ayakkabý boyasýný kullananlarda (p=0,000), >%40 ikinci derece yanýðý olanlarda (p=0,000), >%20 üçüncü derece yanýðý olanlarda (p=0,000), akut solunum yetersizliði geliþenlerde, kompartman sendromun geliþenlerde, hipoalbünemi ve sepsis geliþenlerde (p=0,000) mortalite daha yüksekti.

Anahtar Kelimeler: Haþlanma ve alev yanýðý, hipovolemi; kompartman sendromu; mortalite; sepsis.

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