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Pre-Hospital CPR is a Risk Factor for Early Death in Patients Transferred to an Adult Burn Center
Alisa Savetamal, Shea Gregg, Roselle Crombie, Walter Cholewczynski, *Kristen Glasgow, Nabil Atweh
Bridgeport Hospital, Bridgeport, CT

Objective: evaluate the outcomes of patients transferred to an adult burn center after receiving cardiopulmonary resuscitation (CPR). Design: retrospective chart review. Setting: ABA-verified adult burn center. Patients: adult burn patients transferred from another hospital or from the field. Interventions: standard burn care. Main outcome measures: mortality at and after 48 hours. Results: Burn patients are often transferred to dedicated burn centers for specialized care, and some have undergone CPR. These patients have a significantly higher mortality at 48 hours than those who have not. An IRB-approved review of burn transfer deaths from 2012 to 2015 reveals that of 36 burn transfers resulting in death, 15 occurred within 48 hours (“early”). Of these, 9 (60%) had undergone CPR prior to transfer. By comparison, of the 22 “late” deaths, only 1 (4.5%) had undergone pre-hospital CPR. Pre-hospital CPR is significantly associated with early death (p<.003). There were no significant differences between the groups with respect to age (p=0.23) or TBSA (p=0.45); there was a significant association with inhalation injury (11 “early” vs 8 “late” patients; p=0.045). Interestingly, 46.7% of the early deaths were transferred directly from the field, compared with 22.7% of late deaths (p =0.07). Conclusions: Patients who have undergone CPR prior to transfer are at high risk for death within 48 hours of transfer. The likelihood of a poor outcome, particularly with inhalation injury, must be communicated to the referring centers and patients’ families. Further aggregated study should be undertaken to refine transfer criteria for referring hospitals and first responders managing patients requiring CPR after burn injury.

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Back to 2016 Annual Meeting Posters