Predictors of Mortality in Work-related Burn Injures: A Multivariate Analysis.

Abstract

This study aims to identify prognostic factors influencing mortality among work-related burn patients in Northern Vietnam. A retrospective cohort study was conducted on 395 work-related burn patients admitted to the Vietnam National Burn Hospital (VNBH) from January 1 to December 31, 2023. Patient data were extracted from the VNBH electronic database, including demographic characteristics, burn severity, first aid interventions, comorbidities, clinical signs, and blood biomarkers. Univariate and multivariate logistic regression analyses were applied to determine independent predictors of mortality. The study population comprised 310 men (78.5%) and 85 women (21.5%), with a mean age of 36.7±12.9 years. Most patients were workers (87.9%) and resided in rural areas (52.7%). The predominant causes of burns were flames (46.1%) and electrical injuries (34.4%). The majority of patients (74.4%) sustained full-thickness burns, with 50.4% having a total burn surface area (TBSA) <20%. The overall mortality rate was 12.2%. Univariate analysis identified significant associations between mortality and fluid resuscitation (p=0.01), burn shock (p<0.001), facial burns (p<0.05), inhalation injury (p<0.001), full-thickness burns >20% (p<0.001), and complications (p<0.001). Multivariate analysis revealed that incorrect or absent fluid resuscitation (OR=2.3), burn shock (OR=3.7), facial burns (OR=3.5), neuropathy (OR=5.1), respiratory disease (OR=3.3), full-thickness burns (21-49%) (OR=4.2), serum glucose ≥9 mmol/L (OR=3.0), inhalation injury (OR=7.3), and full-thickness burns >50% (OR=6.7) were significant independent predictors of mortality (p<0.05). Work-related burn injuries remain a significant occupational hazard in Northern Vietnam. Factors such as inhalation injury, extensive full-thickness burns, burn shock and hyperglycemia substantially increase mortality risk. Early and appropriate fluid resuscitation, improved first aid measures, and better management of comorbidities are crucial for improving survival rates.