Prediction of Development of Acute Gastroduodenal Complications in Patients With Severe Burns

Abstract

OBJECTIVES: Our aim was to find whether we could predict the likelihood of acute gastroduodenal complications developing in patients with severe burns. MATERIALS AND METHODS: From 2018 to 2020, there were 85 patients with extensive thermal injury and severe burns who were hospitalized at our burn department (Samarkand City Medical Association). Of these, 45 patients (53%) developed acute gastroduodenal complications in the first 7 days postinjury and 40 (47%) did not develop these complications in the first 2 weeks after admission. We analyzed the following 7 parameters: admission time and initiation of intensive care after 12 hours, total burn area of ≥40%, deep burn area ≥10%, lesion severity index (Frank index) of ≥130 units, development of thermal inhalational lesion in the respiratory tract, duration of mechanical ventilation of >48 hours, and history of peptic ulcer disease of >5 years. RESULTS: We found that 57.8% of patients who had postponed hospitalization in a specialized medical institution and started intensive therapy >12 hours later developed acute gastroduodenal complications versus 42.2% of patients without these factors. In those with total burn area <40% and ≥40%, 28.9% versus 71.1% developed acute gastroduodenal complications. At week 2 of burn disease, in patients with deep burn areas ≥10%, acute gastroduodenal complications developed 1.5 times more often. Among patients whose Frank index was ≥130 units, acute gastroduodenal complications developed 9 times more often than among those with Frank index ≤70 units. CONCLUSIONS: The 7 parameters that we used as prognostic criteria could assess patients with extensive thermal injury complicated by the development of burn disease. With these criteria, a scale was created to predict the development of acute gastroduodenal complications. This scale could allow better preparation to treat these complications and to take timely preventive measures.