Survival from burns injuries better than ever before
St Andrews Centre for Plastic Surgery and Burns in Chelmsford, Essex has published new data demonstrating a significant reduction in patient deaths from serious burn injuries, with survival rates now as good as the best published data worldwide.
The findings are reported in a recent paper authored by the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) member Professor Peter Dziewulski, Consultant Plastic and Reconstructive Surgeon and Clinical Director at the Chelmsford Burn Service.
The data shows that the survival rate for patients with major burn injuries has significantly improved. For children and young adults in the 1980s the chances of surviving a 50% body surface area burn were 50:50, now a similar survival probability is seen in children with burns approaching 100% of their body and young adults with burns of 75%. Analysis of patients undergoing surgery for major burn injury also shows that in the 1980s four out of five patients would die whereas now four out of five patients are expected to survive.
This is the first time a UK service has shown equivalence to best international data. There has been consistent improvement in outcome particularly in the paediatric and young adult age group. The paper authors believe that the data does mean that certain traditional measures used to predict burns mortality, such as the ‘Baux’ score, are no longer as accurate.
Professor Dziewulski commented,
“The impressive data in this study is a tribute to the fortitude and resilience of our patients and the hard work and dedication of all the staff who work in the Burn Service. Such improvements in outcome have been made possible by collaborative working of a large multidisciplinary team led by plastic surgeons focusing on patient-centred care.”
Thankfully major burns injuries are still rare and emergency physicians are unlikely to see more
than a handful of patients with life threatening burns in their careers. However, as an increasing number of patients survive, Professor Dziewulski and his team believe there should be more thought given to improving their physical and psychosocial rehabilitation.
About the study
The research paper is titled ‘The Baux score is dead. Long live the Baux score: A 27-year retrospective cohort study of mortality at a regional burns service. Authored by Geoffrey Roberts, MA, BM BCh, MRCS, Mark Lloyd, MRCS, Mike Parker, MSc, Rebecca Martin, FRCA, Bruce Philp, FRCS, Odhran Shelley, FRCSI, and Peter Dziewulski, FRCS, Chelmsford, United Kingdom.
The aim of the study was to assess trends in mortality after burn injuries treated in a regional specialist burns service between 1982 and 2008.Patient and burn-specific information and mortality were collated from written admission ledgers and the hospital coding department for 11,109 patients. The data set was divided into age cohorts (0 –14, 15– 44, 45– 64, and _65 years) and time cohorts (1982–1991, 1992–2000, and 2000 –2008). Lethal area 50 (LA50) was calculated by logistic regression and probit analysis. Mortality was related to the Baux score (age _ total % burned surface area) by logistic regression.
The paper has been published in the Journal of Trauma, Volume 72.
BAPRAS, the British Association of Plastic, Reconstructive and Aesthetic Surgeons, is the voice of plastic surgery in the UK. It aims to increase the understanding of the professional specialty and scope of plastic surgery, promoting innovation in teaching, learning and research.
Founded in 1946 (originally as the British Association of Plastic Surgeons), today BAPRAS has over 800 members and is the professional representative body for reconstructive and aesthetic Plastic Surgeons providing services to patients on the NHS and privately in the UK.
Members of the public can find a member Plastic Surgeon in their area by logging on to www.bapras.org.uk. Anyone can check the GMC to find out if a surgeon is on the plastic surgery specialist register; http://www.gmc-uk.org/register/search/index.asp