Clinical trial NCT04480944: Massive Burns: Retrospective Analysis of Changes in Outcomes Across 18 Years
Official title: Massive Burns: Retrospective Analysis of Change in Outcomes Across 18 Years
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Burns
Keywords: Massive burns
Intensive care unit
Burn surgery
Burn infections
Skin grafts
Critical illness
Cultured epithelial autografts
Nutrition
Glucose
Lead sponsor: Centre Hospitalier Universitaire Vaudois
Sponsor class: OTHER
First posted: 2020-07-22
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Adults patients with extremely large burns (massive burn \>50% TBSA) admitted and treated from beginning to end in the burn intensive care unit of a university hospital burn center in Switzerland

Brief summary: Burns treatment and management has evolved since the 90s, particularly for massive burns (≥ 50% of total body surface area (TBSA)). This study aims at analyzing the impact of the management changes on the length of intensive care unit (ICU) stay, the take of skin grafts and the mortality.

Detailed description: Review of all massively burned patients treated at Lausanne University Hospital burn intensive care unit (ca. 40-60 patients). Analysis of changes in length of intensive care unit stay (LICU), skin graft take rate or mortality between 2000 and 2018.

Hypothesis : the optimization of resuscitation procedures and of nutrition therapy combined with the use of novel surgical techniques has brought a significant improvement in outcomes.

Association between outcomes and year of admission will be assessed through correlation analysis and logistic regression analysis. Potential cofounders will be assessed through stepwise linear regression analysis

Eligibility criteria: Inclusion Criteria:

* All adult patients (\>18 years old) with burns ≥50% TBSA admitted in the burn intensive care unit (ICU) of the Lausanne University Hospital

Exclusion Criteria:

* Patients admitted in the burn center ICU with another primary diagnosis than burn (e.g. necrotizing fasciitis, gangrene, toxic epidermal necrolysis)
* Patients referred from and/or to another ICU
* Patients in which active withdrawal of care was decided within 48h of admission
* Patients with first degree burns only

Primary outcomes:
measure: LICU/Percent TBSA
timeFrame: 18 years
Secondary outcomes:
measure: Percent TBSA grafted/ Percent TBSA deep burns
timeFrame: 18 years
measure: Daily nutritional intakes
timeFrame: 18 years
measure: Mortality
timeFrame: 18 years
Other outcomes:
Locations:
city: Lausanne
country: Switzerland
facility: Adult ICU and Burn ICU, Lausanne University Hospital
state: Vaud
Study officials:
affiliation: CHUV
name: Wassim Raffoul, MD
role: STUDY_DIRECTOR
References:
citation: Pantet O, Stoecklin P, Vernay A, Berger MM. Impact of decreasing energy intakes in major burn patients: A 15-year retrospective cohort study. Clin Nutr. 2017 Jun;36(3):818-824. doi: 10.1016/j.clnu.2016.05.007. Epub 2016 May 24.
citation: Brusselaers N, Hoste EA, Monstrey S, Colpaert KE, De Waele JJ, Vandewoude KH, Blot SI. Outcome and changes over time in survival following severe burns from 1985 to 2004. Intensive Care Med. 2005 Dec;31(12):1648-53. doi: 10.1007/s00134-005-2819-6. Epub 2005 Oct 12.