Wibbenmeyer L A, Amelon M J, Morgan L J, Robinson B K, Chang P X, Lewis R, Kealey G P
Department of Surgery, The University of Iowa College of Medicine, Iowa City, IA 52242, USA.
Burns. 2001 Sep;27(6):583-90. doi: 10.1016/s0305-4179(01)00009-2.
The purpose of this study was to analyze the outcome of elderly burn victims and to determine an instrument to predict survival in this population. Charts of three hundred and eight burn patients > or =60 yr of age who were admitted to a university-based hospital between the years of 1977-1996 were retrospectively analyzed. The mean age of the population was 71.5+/-8.6, with a male predominance (1.8 to 1, P < 0.001). The majority of the burns were secondary to flame injuries (210, 68.6%). The median body surface area (BSAB) was 13.0% with an in-hospital mortality rate of 30.2%. We demonstrated improved survival in patients aged 60-74 yr as compared to 1965-1971 national burn survival data. A similar trend could not be shown in the very old (> 75 yr of age). Only age and BSAB were related to death by multiple stepwise forward linear regression. The Baux score, which adds age and BSAB, was predictive of outcome in 87.0% of our population. In conclusion, this study reinforces the high mortality associated with burn injuries in the elderly and the superior ability of the Baux score (age + percent burn) in predicting outcome in this population.
本研究的目的是分析老年烧伤患者的预后情况,并确定一种预测该人群生存情况的工具。对1977年至1996年间入住一所大学附属医院的308例年龄≥60岁的烧伤患者的病历进行了回顾性分析。研究人群的平均年龄为71.5±8.6岁,男性占优势(1.8比1,P<0.001)。大多数烧伤继发于火焰伤(210例,68.6%)。中位体表面积(BSAB)为13.0%,住院死亡率为30.2%。与1965年至1971年的全国烧伤生存数据相比,我们发现60至74岁患者的生存率有所提高。在年龄更大(>75岁)的患者中未显示出类似趋势。通过多元逐步向前线性回归分析,只有年龄和BSAB与死亡相关。将年龄和BSAB相加的博克斯评分能够预测87.0%患者的预后。总之,本研究强化了老年烧伤患者烧伤相关的高死亡率以及博克斯评分(年龄+烧伤百分比)在预测该人群预后方面的卓越能力。