Children with burn injuries over 60% of their total body surface area (TBSA) should be immediately transferred to a specialised burns centre for treatment, experts have recommended.
A 10-year study in the US established that a figure of 62% TBSA is the critical mortality threshold for child burn victims, with a positive outcome for patients suffering this degree of injuries much less likely.
The research by David Herndon, MD, from the Shriners Hospital for Children in Galveston, Texas, and colleagues indicates that a much higher threshold for poor outcome exists now than was formerly the case.
The authors noted that a burn size of 40% TBSA was the critical threshold for poor outcome in 1998 when the last major study on child burn injuries was conducted. But due to advances in treatment, the chances of a child surviving such horrific burn injuries has increased.
Their research, published online in The Lancet, found that mortality jumped from 3% in the group of 952 patients with burns over 30% to 39% of their body, to more than half (55%) among those children suffering 90% to 100% burns to their total body surface area.
But they hope that prompt action in cases where the critical mortality threshold has been reached will help improve the child’s chances of survival.
- Kraft R, et al. Burn size and survival probability in paediatric patients in modern burn care: a prospective observational cohort study. The Lancet 2012; Advance online publication.