1.Inhalational injury: The Philippine General Hospital experience (2008-2013).
Jose Joven V. Cruz ; Pinky Dirain-Beran ; Alexandra Monica L. Tan-Gayos
Philippine Journal of Surgical Specialties 2018;73(2):45-51
OBJECTIVE:
Profiling of burn patients with inhalational injury will
lead to better practices in the immediate and supportive management
of their injuries. The goal of this study was to determine demographic
and clinical factors associated with mortality in burn patients with
inhalational injury admitted at Philippine General Hospital - Alfredo
T. Ramirez (PGH - ATR) Burn Center from 2008 to 2013.
METHODS:
All patients who were admitted from 2008 to 2013 were
included in the study. The patient database was searched for cases
of burn patients with inhalation injury. Medical records were
reviewed for further analysis. This study was exempted from review
by the University of the Philippines Manila Research Ethics Board.
RESULTS:
Out of 1900 burn patients included in the study, 134
presented with concomitant inhalation injury with a prevalence rate
of 7.0% and with a mortality rate of 38.06%. The study showed that
the following variables: 1) percent total body surface area (%TBSA),
2) length of time from injury to resuscitation, 3) nebulization with
N-acetylcysteine, 4) development of pneumonia, 5) administration
of systemic antibiotics, and 6) performance of bronchoscopy
correlated significantly with patient outcomes (p<0.05). Other
variables did not show significant correlations with outcomes. The
study also revealed that most of the patients were males with a mean
age of 30.62, who sustained severe burns usually greater than 39%
TBSA.
CONCLUSION
Poorer prognostic indicators include: 1) larger burnt
body surface area, 2) delayed intubation, 3) delayed resuscitation,
and 4) development of pneumonia.
Burns
2.Inhalation injury: A two-year pilot assessment on the adherence to the clinical pathway for adult burn patients at high risk for inhalation injury in the Philippine General Hospital.
Jose Joven V. Cruz ; Mario Emmanuel L. Lopez de Leon ; Alexandra Monica L. Tan-Gayos ; Miriam Quinto ; Jubert P. Benedicto
Philippine Journal of Surgical Specialties 2020;75(2):132-140
OBJECTIVE:
This study determined the mean overall adherence to
the clinical pathway formulated by the Section of Pulmonology
together with the Division of Burns for adult burn patients at high
risk for inhalation injury admitted at the UP-PGH ATR Burn Center
in a two-year period
METHODOLOGY:
A retrospective cohort study regarding adherence
to the clinical pathway of acutely burned adult patients at high risk
for inhalation injury admitted at the UP-PGH ATR Burn Center
between August 2016 to July 2018 was conducted. Medical records
were reviewed and an adherence checklist was used to assess each
item in the clinical pathway. For the adherence and patient profile,
descriptive statistics were used.
RESULTS:
This pilot assessment study showed acceptable rates of
adherence and implementation of the clinical pathway. Overall, 60%
of the cases followed the clinical pathway completely. While 26.67%
had acceptable rates of compliance (more than half of items adhered),
while 13% of the cases scored adhered to less than half of the items.
CONCLUSION
The pathway has been shown to be a feasible clinical
pathway that can be implemented in a tertiary hospital setting.
Burns