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Characteristics of patients resuscitated after burn related out-of-hospital cardiac arrest

  • Tetsuya Hoshino
    Correspondence
    Corresponding author at: 2-1-1 Amakubo, Tsukuba City, Ibaraki Prefecture 305-8576, Japan.
    Affiliations
    Department of Emergency and Critical Care Medicine, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba City, Ibaraki Prefecture 305-8576, Japan
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  • Yuki Enomoto
    Affiliations
    Department of Emergency and Critical Care Medicine, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba City, Ibaraki Prefecture 305-8576, Japan

    Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki Prefecture 305-8577, Japan
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  • Yoshiaki Inoue
    Affiliations
    Department of Emergency and Critical Care Medicine, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba City, Ibaraki Prefecture 305-8576, Japan

    Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki Prefecture 305-8577, Japan
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      Abstract

      Aim

      This study’s objective was to describe the characteristics of burn injury patients who were resuscitated after burn related out-of-hospital cardiac arrest (OHCA).

      Method

      We conducted a retrospective cohort study and examined characteristics of burn related OHCA using data from a Japanese nationwide burn registry that was collected between April 1, 2011 and March 31, 2020. First, we compared the characteristics of burn patients with and without OHCA. Second, among burn patients with OHCA, we compared the characteristics of survivors with non-survivors.

      Results

      In the database, there were 16,995 hospitalised burn patients and 256 burn related OHCA. Thirty-two of the 256 burn patients (13%) survived after admission. Among patients with burns who also had OHCA, flames were the most common injury mechanism (74%); in comparison to all other injury mechanisms, the rate of flame burn was significantly higher in burn patients with OHCA than in burn patients without OHCA. The most common cause of death for burn related OHCA is carbon-monoxide poisoning (46%). Compared with survivors, non-survivors had a larger burn area, greater age and more complications. such as inhalation injuries and perineal burn injuries. Compared to other mechanisms of burn injury, electrical burn injuries were more common among survivors. In twelve patients with electrical burns, eight patients survived (67%) OHCA; of those eight patients, six (50%) could be discharged home.

      Conclusion

      Patients with burn related OHCA have a poor prognosis; however, patients who sustain electrical shock injuries may do better.

      Keywords

      Abbreviations:

      CI (Confidence intervals), %TBSA (% total body surface area), JNBR (Japanese National Burn Registry), JSBI (Japan Society for Burn Injuries)
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