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Thomas K. Varghese, MD; Anthony W. Kim, MD; Areta Kowal-Vern, MD; Barbara A. Latenser, MD

Arch Surg. 2003;138:1292-1296.

Background  Burn-trauma patient encounters constitute 5% of the emergency department population.

Hypothesis  A large urban hospital will treat twice as many (ie, 10%) burn-trauma patients.

Design  Retrospective 44-month study.

Setting  Metropolitan county hospital.

Patients  Population-based sample of burn-only (n = 1102), burn-trauma (n = 120), and assault burn–trauma (n = 43) patients.

Main Outcome Measures  Frequency and demographics.

Results  Just under 10% (n = 120) of the burn population had burn-trauma injuries. The mean ± SD Injury Severity Score was 12 ± 12 in these burn-trauma patients: 4 ± 2 in outpatients and 14 ± 13 in inpatients. The burn-only and burn-trauma groups had similar age ranges, ethnic distribution, frequency of inhalation injury, substance abuse, malnutrition, sepsis, pneumonia, diabetes mellitus, percentage total burn surface area, number of procedures, grafted areas, and mortality. Forty-three burn-trauma patients (35.8%) sustained injuries due to assault, compared with 123 (11.2%) in the burn-only group (P<.001). Burn-trauma patients who were assaulted had a mean ± SD Injury Severity Score of 11 ± 10. There was a significantly increased male-female ratio among the assault burn–trauma patients (6:1) compared with the burn-trauma (3:1) and burn-only (2.3:1) groups (P<.04). Most of these injuries were caused by an unknown assailant, in connection with an automobile, a motorcycle, a bicycle, or pedestrians intentionally struck by moving vehicles, or by child abuse. The main mechanism of injury was contact in 57 burn-trauma patients (47.5%), compared with 127 (11.5%) in the burn-only group (P<.001).

Conclusions  A large urban population will have an increased frequency (2-fold in our center) of burn-trauma injuries. Assault and child abuse are significant contributory factors to burn-trauma injuries in this population.

From the Department of Surgery, Northwestern University Medical Center (Dr Varghese); Department of Surgery, Rush-Presbyterian-St Luke's Medical Center (Dr Kim); and Department of Trauma, Sumner L. Koch Burn Center, John H. Stroger, Jr Hospital of Cook County (Drs Kowal-Vern and Latenser), Chicago, Ill.