Strassle et al identified risk factors associated with nosocomial infection in adult burn patients. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of North Carolina at Chapel Hill and the North Carolina Jaycee Burn Center.
Patient selection: adult burn patient >- 18 years
Outcome: healthcare-associated infection within 60 days of admission
Types of infection:
(1) skin and soft tissue
(2) respiratory tract
(3) sepsis
(4) urinary tract
(5) Clostridium difficile
(6) other
Risk factors for infection:
(1) total burn surface area (see below)
(2) inhalation injury (hazard ratio 1.6)
(3) increased length of stay (up to 40-50% at 60 days)
Burn Surface Area
Adjusted Hazard Ratio
< 5%
1
5 to 10%
2.9
10 to 20%
6.4
> 20%
10
A chemical burn was associated with reduced risk of infection (adjusted HR 0.2). Electrical burns may increase risk (adjusted HR 1.7 but p value 0.07).
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