Clinical Effects of Voltage Difference and The Factors Affecting Mortality in Electrical Injuries

Year 2016, Volume: 8 Issue: 1, 20 - 27, 15.06.2016

Mustafa Icer Yılmaz Zengin

Abstract

Background: The objective of this study is to examine electrical injuries according to high and low
voltages and to investigate the factors affecting mortality.
Methods: In this study, 370 patients presented with electrical injuries were retrospectively
examined. Data in this study included age, gender, cause of electric shock, type of electric shock,
electric voltage, falling down from height, burn degree, total burn surface area (TBSA), organ
injuries, Glasgow Coma Score (GCS), serum enzymes, creatine kinase- myocardial band (CK-MB),
troponin T), developing complications and cardiac arrhythmias. These parameters were compared
in terms of low/high voltage electrical injuries and mortality. P values ≤0.05 were considered
statistically significant.
Results: The mean age was found as 25.81±14.41 (range 1-80, median 24) years. Of the
participants, 301 (%81.4) were male and 69 (%18.6) female patients. Gender, occupational
accident, burn percentage, burn degree, falling from height, Glasgow Coma Score (GCS), enzymes
and complications were significant in terms of low-high voltage difference (p<0.05). In the present
study; suicide, the difference of low-high voltage, 3rd degree burn, low GSC and elevation of LDH,
ALT, AST, CK and troponin enzymes were the factors affecting mortality (p<0.05). Among the
complications; rhabdomyolysis, hyperkalemia, metabolic and respiratory acidosis, pulmonary
hemorrhage and edema were found as the factors influencing mortality (p<0.05).
Conclusion: To distinguish electrical injury according to low-high voltage difference at the time of
first presentation is important in determination of prognosis and mortality. Furthermore suicide
cases, 3rd degree burns and elevated levels of LDH, ALT, AST, CK and troponin T enzymes are
important in order to predict mortality. 

Keywords

Electrical injury; low voltage; high voltage; mortality.

References

• 1. Rai J, Jeschke MG, Barrow RE, Herndon DN. Electrical injuries: a 30-year review. J Trauma. 1999;46(5):933-936.
• 2. Dokov W, Dokova K Epidemiology and Diagnostic Problems of Electrical Injury in Forensic Medicine. Forensic Medicine - From Old Problems to New Challenges. 2011;12 September:121- 36.
• 3. Arnoldo BD, Purdue GF, Kowalske K, Helm PA, Burris A, Hunt JL. Electrical injuries: A 20- year review. J Burn Care Rehabil 2004;25:479-84.
• 4. Vierhapper MF, Lumenta DB, Beck H, Keck M, Kamolz LP, Frey F. Electrical Injury A LongTerm Analysis With Review of Regional Differences. Annals of Plastic Surgery . 2011;66(1):43- 46.
• 5. Blackwell N, Hayllar J. A three year prospective audit of 212 presentations to the emergency department after electrical injury with a management protocol. Postgrad Med J 2002;78:283-5.
• 6. Karadaş S, Gönüllü H, Öncü MR, Işık D, Canbaz Y. The effects on complications and myopathy of different voltages in electrical injuries. Turkish Journal of Trauma & Emergency Surgery 2011;17 (4):349-353.
• 7. Koumbourlis AC, Electrical İnjuries. Crit Care Med 2002;30(11):424-430.
• 8. Cooper MA: Emergent care of lightning and electrical injuries. Semin Neurol 1995;15:268–278.
• 9. Laupland KB, Kortbeek JB, Findlay C, Kirkpatrick AW, Hameed SM. Population-based study of severe trauma due to electrocution in the Calgary Health Region, 1996-2002. Can J Surg. 2005;48(4):289-292.
• 10. Sun CF, Lv XX, Li YJ, Li WZ, Li J, Li J et al. Epidemiological studies of electrical injuries in Shaanxi Province of China: A retrospective report of 383 cases. Burns.2012;38:568-572.
• 11. Acosta AS, Azarcon-lim J, Ramirez AT. Survey of electrical burns in Philippine General Hospital. Ann N Y Acad Sci. 1999;888: 12-18.
• 12. Al B, Aldemir M, Güloğlu C, Kara IH, Girgin S. Epidemiological characteristics of electrical injuries of patients applied to the emergency department. Turkish Journal of Trauma & Emergency Surgery 2006;12:135-42.
• 13. Lipový B, Kaloudová Y, Říhová H, Chaloupková Z, Kempný T, Suchanek I et al. High voltage electrical injury: an 11-year single center epidemiological study. Annals of Burns and Fire Disasters .2014;27(2):82-86.
• 14. Cantürk N, Alkurt Alkan H, Cantürk G. Evaluation of the deaths due to electrıcal currents which performed autopsies between 2002-2006 years in Ankara. Adli Tıp Dergisi 2008; 22(2): 1-7.
• 15. Cherington M. Central nervous system complications of lightning and electrical injuries. Semin Neurol.1995;15:233-40.
• 16. Gokdemir MT, Kaya H, Söğüt Ö, Çevik M. Factors Affecting the Clinical Outcome of LowVoltage Electrical Injuries in Children. Pediatric Emergency Care.2013;29(3):357-359.
• 17. Arrowsmith J, Usgaocar RP, Dickson WA. Electrical injury and the frequency of cardiac complications. Burns.1997;23:576-8.
• 18. Bailey B, Gaudreault P, Thivierge RL. Cardiac monitoring of high-risk patients after an electrical injury: a prospective multicentre study. Emerg Med J 2007;24:348–352.
• 19. Carleton SC. Cardiac problems associated with electrical injury. Cardiol Clin 1995;13:263-6.