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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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Outcome predictors and quality of life of severe burn patients admitted to intensive care unit
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine2010, 18:24 doi:10.1186/1757-7241-18-24 Vittorio Pavoni (pvv@unife.it) Lara Gianesello (gianesello.lara@libero.it) Laura Paparella (laura_paparella@libero.it) Laura Tadini Buoninsegni (lauratadini@libero.it) Elisabetta Barboni (pvv@unife.it)

ISSN Article type Submission date Acceptance date Publication date Article URL

1757-7241 Original research 28 November 2009 27 April 2010 27 April 2010http://www.sjtrem.com/content/18/1/24

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Outcome predictors and quality of life of severe burn patients admitted to intensive care unit

Vittorio Pavoni, Lara Gianesello*, Laura Paparella, Laura Tadini Buoninsegni, Elisabetta Barboni

Department of Critical Medical-Surgical Area, Section of Anesthesia and Intensive Care, Largo Palagi, 1. 50139 Firenze, Italy

*Corresponding author

E-mailaddresses: VP- pvv@unife.it LG- gianesello.lara@libero.it LP- laura_paparella@libero.it LTB- lauratadini@libero.it EB- pvv@unife.it

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Abstract Background: Despite significant medical advances and improvement in overall mortality rate following burn injury, the treatment of patients with extensive burns remains a major challenge for intensivists. We present a study aimed to evaluate theshort- and the long-term outcomes of severe burn patients (total body surface area, TBSA>40%) treated in a polyvalent intensive care unit (ICU) and to assess the quality of life of survivors, one year after the injury using the EuroQol-5D (EQ-5D) questionnaire. Methods: A prospective-observational study was performed in an ICU of a Universityaffiliated hospital. Logistic regression analysis was used toidentify the factors predicting inhospital mortality. The EQ-5D questionnaire was used to asses participant’s long term selfreported general health. Results: During a period of five years, 50 patients participated in the study. Their mean age was 53.8±19.8; they had a mean of %TBSA burned of 54.5±18.1. 44% and 10% of patients died in the ICU and in the ward after ICU discharge, respectively. Bauxindex, SAPS II and SOFA on admission to the ICU, infectious and respiratory complications, and time of first burn wound excision were found to have a significant predictive value for hospital mortality. The level of health of all survivors was worse than before the injury. Problems in the five dimensions studied were present as follows: mobility (moderate 68.5%; extreme 0%), selfcare (moderate21%; extreme 36.9%), usual activities (moderate 68.5%; extreme 21%), pain/discomfort (moderate 68.5%; extreme 10.5%), anxiety/depression (moderate 36.9%; extreme 42.1%). Conclusions: In severe burn patients, Baux index, severity of illness on admission to the ICU, complications, and time of first burn wound excision were the major contributors to

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hospital mortality. Quality of life was...