TUESDAY, Jan. 31 (HealthDay News) -- Children with burns covering 60 percent of their body or more are at much higher risk for complications and death and should receive specialized care, according to a study published online Jan. 31 in The Lancet.
To identify the burn size associated with significant increases in morbidity and mortality, Robert Kraft, M.D., from the University of Texas Medical Branch in Galveston, and colleagues reviewed clinical data for 952 pediatric patients (mean age, 7.3 years) with burns affecting at least 30 percent of their total body surface area (TBSA).
The researchers found that mortality was 13 percent overall and ranged from 3 percent for patients with 30 to 39 percent TBSA to 55 percent for patients with 90 to 100 percent TBSA. Multi-organ failure occurred in 16 percent of patients overall and increased from 6 percent in the 30 to 39 percent TBSA group to 45 percent in the 90 to 100 percent TBSA group. Sepsis occurred in 9 percent of patients overall, increasing from 2 to 26 percent in the two groups, respectively. The authors determined that a 62 percent burn size was the crucial threshold for mortality (odds ratio, 10.07).
"On the basis of these findings, we recommend that pediatric patients with greater than 60 percent TBSA burns be immediately transferred to a specialized burn center," Kraft and colleagues conclude. "Furthermore, at the burn center, patients should be treated with increased vigilance and improved therapies, in view of the increased risk of poor outcome associated with this burn size."
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