Impact of organ dysfunction on overall survival in patients with burns ≥ 70% TBSA: A case-control study.

Abstract

Despite advancements in burn care, the mortality rate for patients with burns ≥ 70% TBSA remains high. Complications like multiple organ dysfunction (MODS), sepsis, and infection are leading causes of death. However, the impact of individual organ dysfunction on survival in these patients has not been comprehensively studied. This study analyzed 144 patients with burns ≥ 70% TBSA treated at the First Affiliated Hospital of Naval Military Medical University from 2010 to 2020. Patients were categorized into alive or dead groups based on overall survival (OS) status. Univariate analysis using the Pearson chi-square test and Kaplan-Meier (KM) survival analysis explored the relationship between organ dysfunction and OS. Multivariate Cox regression analysis confirmed the independent predictive efficacy of organ dysfunction, and a nomogram was constructed to predict OS probability at different time points. Significant differences in OS were observed between patients with and without organ dysfunction (p < 0.001). Each specific organ dysfunction was significantly associated with worse survival. Multivariate Cox regression showed that organ dysfunction significantly reduced OS probability (OR = 11.37, 95% CI = 5.68-22.7, p < 0.001). The nomogram provided accurate OS probability predictions (AUC at 1 week = 0.821, 4 weeks = 0.943, 8 weeks = 0.927, 12 weeks = 0.925). Organ dysfunction is a significant factor affecting OS in patients with burns ≥ 70% TBSA. The survival prognosis of patients with organ dysfunction is worse due to multiple pathophysiological mechanisms. Effective burn care strategies to prevent or manage organ dysfunction are urgently needed. Early detection and management of organ dysfunction are crucial for improving survival rates in burn patients. The nomogram developed in this study can aid in clinical decision-making and personalized treatment planning, highlighting the need for targeted therapeutic interventions to mitigate organ dysfunction.