Futile care in Kirkuk teaching hospital burn unit.

Abstract

        Background; Futile care; a medical term applied when there is no reasonable hope of improvement or cure in spite of expense of medical or surgical care. Futile care decision governed by a variety of scoring systems to evaluate clinical situation and direct medical effort in respecting the patient requirement, surrogate allowance. Where and when the medical treatment being futile is another view must be sought for afflicted patient. 

        Materials & methods; This is a retrospective study about admitted patient over 7 years (since January 2012-until December 2018) were 2076 patient  (total admission number) in Kirkuk teaching hospital burn unit, of them (1284 female, 762 male burns casualty) 74% of them are saved but (26%) 538 patient  are dead out of total number of admission , (21%) 435 patient were with expected death, but (5%) 103 {(79 pediatric less than 12 years) and (24 patient age more than 56 years)} with un expected death the latter were succumbed to sepsis even with our best available rescue management.

        Result; This study on those (21%) 435 patients (with more than 55% BSAB. & mostly associated with inhalational injury) sex variation{23 male (25-55 years) , 412 female (13-45years)}most of them self-immolation; who are falls under the known guide lines {DNR=Do Not Resuscitate} comfort care applied to them, we depend on  R-Baux score to predict the probability of death after burn injury was calculated for each patient by following formula:

(TBSA + age + [17×R]). {R=1 if patient has inhalation injury and R=0 if not}.

       Aim; of our study is to evaluating our working in spite of our challenges in Iraq circumstances.

    we used different formulae to predict mortality in burn casualties to reach best results we could approach to it.

       Conclusion; our results show more increases in the mortality % than American and European studies because we have less facilities and limited resources.