Hunt J L, Purdue G F
Parkland Memorial Hospital, Dallas, Texas.
Am J Surg. 1992 Nov;164(5):472-6. doi: 10.1016/s0002-9610(05)81183-3.
During a 16-year period, 547 patients who were older than 64 years of age with a mean total body surface area (TBSA) (third-degree burns) of 25% were treated. Etiologies were flame/flash in 81% of patients, scald in 11%, solids in 7%, and electrical/chemical in 1%. Seventeen percent of patients had significant causal factors. An inhalation injury was present in 13% of patients, and the mortality in these patients was 100%. Burn excision was performed 239 times in 165 patients. The majority of excisions were for full-thickness burns. Excision did not improve overall survival in patients with third-degree burns of 0% to 10%, but the length of stay (LOS) in excised and nonexcised survivors was improved (9 versus 21 days, respectively). The LOS and survival were not significantly different in patients with burns between 11% and 20%. Postburn complications occurred in 28% of patients. Overall mortality was 50% (mean age: 77 years; TBSA: 40%). There were no survivors with over 47% TBSA burns. The leading cause of death was pulmonary sepsis. Most surviving patients returned to a satisfactory lifestyle after discharge.
在16年期间，对547名64岁以上、平均全身表面积（TBSA）（三度烧伤）为25%的患者进行了治疗。病因方面，81%的患者为火焰/闪燃伤，11%为烫伤，7%为固体接触伤，1%为电击/化学伤。17%的患者有显著的因果因素。13%的患者存在吸入性损伤，这些患者的死亡率为100%。165名患者共进行了239次烧伤创面切除。大多数切除是针对全层烧伤。对于0%至10%三度烧伤的患者，切除并不能提高总体生存率，但切除组和未切除组的存活患者住院时间均有所改善（分别为9天和21天）。11%至20%烧伤患者的住院时间和生存率无显著差异。28%的患者发生烧伤后并发症。总体死亡率为50%（平均年龄：77岁；TBSA：40%）。TBSA烧伤超过47%的患者无幸存者。主要死亡原因是肺部感染。大多数存活患者出院后恢复到了满意的生活状态。
