Archives of Academic Emergency Medicine

Vol. 14 No. 1 (2026)

Associated Factors of In-hospital Mortality in Adult Burn Patients: A Five-Year Retrospective Study

Archives of Academic Emergency Medicine, Vol. 14 No. 1 (2026), 1 October 2025 , Page e55
https://doi.org/10.22037/aaem.v14i1.3093

Abstract

Introduction: Although comorbidities are recognized as important prognostic factors in burn patients, the impact of individual comorbidities and associated trauma on treatment outcomes has not been fully elucidated. This study aimed to evaluate the associations between individual comorbidities, the presence of comorbidities, associated trauma, and treatment outcomes in adult burn patients. Methods: A retrospective cohort study was conducted among all eligible adult burn patients (aged ≥18 years) admitted to Le Huu Trac National Burn Hospital, Vietnam, between January 2021 and December 2025. The primary outcome was in-hospital mortality. Demographic characteristics, burn characteristics, comorbidities, and associated trauma were extracted from the electronic medical records. Univariate and multivariate regression analyses were performed to identify factors independently associated with the study outcomes. Results: The study included 6653 adult burn patients with median age of 40 (interquartile range (IQR): 31 – 52) years (73.94% male). Among adult burn patients, hypertension and diabetes mellitus were the most common comorbidities (3.01% and 2.80%, respectively). The presence of comorbidities was an independent predictor of both complications and mortality (odds ratio (OR) = 1.926, 95% confidence interval (CI): 1.180–3.144, p = 0.009; and OR = 1.785, 95% CI: 1.057–3.014, p = 0.030, respectively), along with age, total burn size, full-thickness burn size, and inhalation injury (all p < 0.001). Chronic pulmonary disease (OR = 11.371, 95% CI: 2.972–43.498, p < 0.001) and paralysis (OR = 3.451, 95% CI: 1.085–10.976, p = 0.036) remained independent predictors of mortality. Associated trauma was independently associated with prolonged hospital stay (p = 0.033). Conclusions: Comorbidities were independently associated with both complications and mortality in adult burn patients. Chronic pulmonary disease and paralysis were identified as independent prognostic factors for mortality. Although associated trauma was not independently associated with mortality, it was independently associated with a prolonged hospital stay.

Keywords:
  • Burns
  • Comorbidity
  • Mortality
  • Prognosis

How to Cite

1.
Tran HD, Ngo HT, Nguyen LN, Nguyet Tran ML. Associated Factors of In-hospital Mortality in Adult Burn Patients: A Five-Year Retrospective Study. Arch Acad Emerg Med [Internet]. 2026 Sep. 21 [cited 2026 Sep. 28];14(1):e55. Available from: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/3093

References

1. Zhang Y, Chen Q, Wang R, Guo L, Li P, Deng K, et al. Global trends in thermal burn burden, 1990–2021: a comprehen-sive analysis for the global burden of disease study 2021. Front Public Health. 2025;13:1631138.

2. Huang S, Lin H-Z, Wei X. Global, regional and national bur-den of injuries caused by fire, heat, and hot substances from 1990 to 2021. Plos one. 2025;20(5):e0324481.

3. Wardhana A, Wibowo J. Predicting mortality in burn pa-tients: literature review of risk factors for burn mortality and application in scoring systems. Ann Burns Fire Disasters. 2023;36(1):3.

4. Rahimpour A, Clower L, McDonald A, Young S, Reeves H, Cassier T, et al. Clinical and Demographic Predictors of Sur-vival in Elderly Burn Patients Aged 65 and Older: A Retro-spective Analysis in an Appalachian Cohort. Cureus. 2025;17(4):1-7.

5. Cueva‐Ramírez JE, Valdez R, Tejada R, Gonzalez‐Alcaide G, Ramos‐Rincon JM. Epidemiological Characteristics and Prog-nostic Factors for Mortality in Severe Burns: A 32‐Year Anal-ysis (1993–2024) From a National Referral Center in the Dominican Republic. World J Surg. 2026;50(5):1159-68.

6. Atkins K, Schneider A, Rodriguez C, Gallaher J, Charles A. The predictive probability of mortality in the presence of full-thickness burns. Am J Surg. 2023;225(4):793-9.

7. Lam NN, Duc NM, Hung NT. Influence of pre-existing med-ical condition and predicting value of modified Elixhauser comorbidity index on outcome of burn patients. Burns. 2020;46(2):333-9.

8. Sljivic S, Agala CB, McLean SE, Williams FN, Nizamani R, Meyer AA, et al. Outcomes in pediatric burn patients with additional trauma-related injuries. Am Surg. 2023;89(7):3229-31.

9. Hörbrand F, Schrank C, Henckel-Donnersmarck G, Mühlbauer W. Integration of preexisting diseases and risk factors in the Abbreviated Burn Severity Index (ABSI). Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerz-therapie: AINS. 2003;38(3):151-7.

10. Germann G, Barthold U, Lefering R, Raff T, Hartmann B. The impact of risk factors and pre-existing conditions on the mortality of burn patients and the precision of predictive admission-scoring systems. Burns. 1997;23(3):195-203.

11. Thombs BD, Singh VA, Halonen J, Diallo A, Milner SM. The effects of preexisting medical comorbidities on mortality and length of hospital stay in acute burn injury: evidence from a national sample of 31,338 adult patients. Ann Surg. 2007;245(4):629-34.

12. Krasnoff CC, Grigorian A, Chin T, Joe V, Kong A, Barrios C, et al. Pediatric burn-trauma patients have increased length of stay compared to trauma-only patients: a propensi-ty matched analysis. Burns. 2021;47(1):78-83.

13. Brandão C, Meireles R, Brito I, Ramos S, Cabral L. The role of comorbidities on outcome prediction in acute burn pa-tients. Annals of burns and fire disasters. 2021;34(4):323.

14. Heng JS, Clancy O, Atkins J, Leon-Villapalos J, Williams AJ, Keays R, et al. Revised Baux Score and updated Charlson comorbidity index are independently associated with mortal-ity in burns intensive care patients. Burns. 2015;41(7):1420-7.

15. Salehi SH, As’adi K, Abbaszadeh-Kasbi A. The prevalence of comorbidities among acute burn patients. Trauma. 2019;21(2):134-40.

16. Knowlin L, Stanford L, Moore D, Cairns B, Charles A. The measured effect magnitude of co-morbidities on burn injury mortality. Burns. 2016;42(7):1433-8.

17. Bagheri M, Fuchs PC, Lefering R, Grigutsch D, Busche MN, Niederstätter I, et al. Effect of comorbidities on clinical out-come of patients with burn injury—An analysis of the Ger-man Burn Registry. Burns. 2021;47(5):1053-8.

18. Fedor CJ, Arellano JA, Liu HY, Kaulakis MG, Corcos AC, Siedsma MP, et al. Clearing the Air: Impact of COPD on Inha-lation Injury Outcomes. Journal of Burn Care & Research. 2025;46(4):746-52.

19. Stephens T, Papp A, Papp B, Sheikh-Oleslami S, Griesdale D, Jain F. 61 effect of pre-existing hypertension on cardiovas-cular support and mortality among major burn patients. Journal of Burn Care & Research. 2023;44(Supplement_2): S28-S9.

20. Almeida A, Alvarenga V, Egipto P, Costa-Ferreira A, Horta R, de Carvalho FM. Clinical outcomes among elderly people with burns. Annals of burns and fire disasters. 2023;36(3):191.

21. Mattick JS, Yang Q, Orman MA, Ierapetritou MG, Berth-iaume F, Gale SC, et al. Impact of burn priming on immune and metabolic functions of whole Liver in a rat cecal ligation and puncture model. Int J Burn Trauma. 2013;3(1):55.

22. Al-Mousawi AM, Mecott-Rivera GA, Jeschke MG, Herndon DN. Burn teams and burn centers: the importance of a com-prehensive team approach to burn care. Clin Plast Surg. 2009;36(4):547.

23. Grigorian A, Nahmias J, Schubl S, Gabriel V, Bernal N, Joe V. Rising mortality in patients with combined burn and trauma. Burns. 2018;44(8):1989-96.

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