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Risk Factors for Mortality and Prolonged Hospitalization in Electric Burn Injuries.

BACKGROUND
Electrical injuries are rare, but very destructive with high morbidity and mortality, prolonged hospital length of stay and need for repeated procedures. The aim of study was to investigate characteristics and management electrical injuries and predisposing factors for mortality and prolonged length of stay.


METHODS
Patient charts were reviewed retrospectively to identify patients admitted with electrical injuries at the Zurich Burns Center (2005-2019). Patient characteristics, management and outcome were analyzed and risk factors for mortality and prolonged hospitalization assessed.


RESULTS
89 patients were included, mostly males (86.5%), between 21-40-years (50.6%), with high-voltage (74.2%) occupational injuries (66.3%). Median intensive care unit and hospital stays were 6 (1st and 3rd IQR: 2.0; 30.0) and 18 (9.0; 48.0) days. Low-voltage patients had a median of 2 (1.5; 3.0) procedures, compared to 4 (2.0; 10.8) in high-voltage. Amputation rate was 13.5%, and a total of 46 flaps required. Fifty-four patients had at least one serious complication. Mortality was 18% in high-voltage patients, mostly after multiple organ failure (35%). High TBSA, renal failure and cardiovascular complications were risk factors for mortality (p<0.001) in multivariate regression models. Determinants for prolonged hospital stay were TBSA and sepsis (p<0.01), and additionally abdominal complications and limb loss for intensive care unit stay (p<0.05).


CONCLUSIONS
Electrical injuries are still cause of significant morbidity and mortality, mostly involve young men in their earning period. Several risk factors for in-hospital mortality and prolonged stay were identified and can support physicians in the management and decision-making in these patients.