Determinants of mortality among adult burn patients admitted to a regional burn center: a fifteen-year review

Introduction Age, total body surface area (TBSA), and inhalation injury are well-established predictors of mortality following burn injury. However, contemporary institutional data are needed to evaluate additional determinants of mortality and assess temporal trends in modern burn care systems. This study examined mortality predictors and longitudinal trends among adult burn patients admitted to a regional burn center over a fifteen-year period, specifically to determine whether the mortality rate changed significantly over the study period. Methods A retrospective review was conducted of 4117 adult burn patient records from an institutional burn registry, admitted between 2007 and 2021. Patients younger than 18 years and those with missing essential data were excluded. Demographic variables, burn characteristics, TBSA, inhalation injury, injury mechanism, comorbidities, length of stay, ICU days, and ventilator days were analyzed. Statistical tests included chi-square, Wilcoxon rank-sum, Cochran–Armitage trend test, Jonckheere–Terpstra test, and logistic regression. Results Among 4117 patients, 161 (3.9%) died. Non-survivors were significantly older than survivors (61.25 ± 17.99 vs. 44.47 ± 17.29 years; p < 0.0001) and sustained larger burns (mean TBSA 39.51 ± 30.27% vs. 6.36 ± 9.23%; p < 0.0001). Flash/flame injuries accounted for the majority of deaths (72.67%; p < 0.0001). Inhalation injury was substantially more frequent among non-survivors than survivors (39.1% vs. 6.7%; p < 0.0001). Non-survivors required significantly more ICU days (6.92 ± 14.79 vs. 3.20 ± 9.44; p < 0.0001) and ventilator days (5.89 ± 12.88 vs. 1.86 ± 7.66; p < 0.0001). They also experienced more complications (1.54 ± 1.10 vs. 0.42 ± 0.92; p < 0.0001) and had a greater comorbidity burden (1.41 ± 1.03 vs. 1.21 ± 0.99; p = 0.0079). Overall mortality did not significantly change over time ( p = 0.0523). Conclusion Age, TBSA, inhalation injury, and comorbidity burden were associated with mortality in adult burn patients, corroborating determinants established in prior literature. Over the fifteen-year period, institutional mortality did not change significantly, while patient age, comorbidity burden, and injury severity among non-survivors increased over time.