Burns Open (Oct 2020)
Estimation of survival rate in electrical injuries, experience in Algerian Burn Centers
Abstract
The mortality rate due to electrical accidents remains very high in developing countries. It is well known that burns and electrical injuries are responsible for complex multi organic issues in association with burns that need an organized therapeutic strategy that must be given at the right time. This study aims to estimate the survival function of electrical injury during a defined time-period after identifying mortality prognostic factors in Algerian’s Burn Centers. Methods: This is a prospective multi-Center prognostic study that was led in Algiers, from June 2007 to September 2015 and conducted on 200 patients with electrical injuries.A standard therapeutic algorithm was followed in the evaluation and management of the patients.A simple logistic regression was used to identify the prognostic factors of mortality, and Kaplan and Meier survival curves study, with the Log-rank test, were used to measure the overall survival rates of the exposed population. Results: The mortality rate in this study was 20%. Logistic regression analysis resulted in the following risk factors of mortality: acute renal failure (p = 0.000, OR = 40), sepsis (p = 0.000, OR = 56.9), fall or projection traumatic injury (p = 0.004, OR = 4.3), total body surface area over 50% (p = 0.000, OR = 11.6), and lack of skin coverage (p = 0.000, OR = 0.035). In this study, the time factor was defined as the delay between the day of the accident and the day of the admission in the emergency unit. This time corresponds to the beginning of the overall treatment. Its importance was determined by using the survival curves analysis. All the identified prognostic factors were associated with a low survival rate (p < 0.001). The probability to survive to an electrical injury was 86% when the patient was admitted to the emergency unit on the day of the accident. Conclusion: Electrical burns are responsible for high mortality and disability rates. In this paper, we showed, through the results, the link between several risk factors and mortality, and the influence of the delay in the overall therapeutic management, on the survival rate.
