584 Major Outcomes After Chemical Injury from the American Burn Association Burn Research Dataset

TL;DR

This study compares outcomes of chemical burns to non-chemical burns using a large US dataset, finding shorter hospital stays and lower mortality rates for chemical burns.

Contribution

The study provides new insights into the clinical outcomes of chemical burns compared to non-chemical burns using a national dataset.

Findings

Chemical burn admissions were associated with significantly lower mortality rates and ICU utilization.

Patients with chemical burns had shorter hospital stays and lower rates of acute respiratory distress syndrome.

Chemical burns represented 3.1% of all burn admissions in the dataset.

Abstract

Chemical burns often cause continuous tissue damage beyond their initial exposure, increasing the complexity of managing this type of burn injury. While the principles of management of chemical burns are similar to those for thermal burns, conventional management additionally involves prompt decontamination and extensive irrigation. This study investigates the outcomes for individuals with chemical burn injuries compared to those with non-chemical burn injuries.

The American Burn Association (ABA) Burn Research Dataset was queried for admissions from 2012-2021 related to chemical or corrosion burns. The primary outcome assessed was mortality. Secondary outcomes were deep venous thromboembolism (DVT), hospital length of stay (LOS), ICU utilization, pneumonia, and respiratory failure. Minor complications included cellulitis, unplanned intubation, systemic sepsis, renal failure, cardiac arrest, and arrhythmia. A multivariate regression analysis was performed while controlling for the following covariates (age, sex, TBSA%, and inhalation injury) for these outcomes. Chi-square analysis was performed to analyze demographic and minor complication associations. Data analysis was done within the Python Language with PyCharm 3.1 software using the pandas and scipy.stats modules.

Of the 285,544 admissions within the dataset, 8,719 (3.1%) were related to chemical or corrosion burns. Admissions due to chemical burns were significantly more likely to be male (p < 0.05) and white (p < 0.05). Patients with chemical burns were significantly less likely to have acute respiratory distress syndrome (ARDS, p < 0.05). After adjusting for covariates, those with chemical burns had significantly lower mortality rates (p < 0.005) and ICU admission (p < 0.001). Admissions for chemical burns were also associated with a roughly 1.02-day shorter hospital LOS (p < 0.001). There were no significant differences for all other major and minor complications.

Chemical burns represent a small percentage of burn injuries in the US. This study shows that chemical burns were associated with shorter hospital stays and decreased rates of ARDS, mortality, and ICU utilization compared to non-chemical burn injuries. Further research is required to understand long-term outcomes for individuals with chemical burn injuries as well as how initial management of these burns impacts clinical outcomes.

Given that the mechanism and pathophysiology of chemical burns is distinct compared to non-chemical burn injuries, individuals with these injuries may require more specific assessment tools to better understand initial management and long-term sequelae of chemical burn injuries.

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