Haik Josef, Liran Alon, Tessone Ariel, Givon Adi, Orenstein Arie, Peleg Kobi
Burn Unit, Department of Plastic Surgery & Reconstructive Surgery, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer.
Isr Med Assoc J. 2007 Sep;9(9):659-62.
Burns are a major public health problem, with long hospitalization stay in both intensive care units and general wards. In Israel about 5% of all hospitalized injuries are burn injuries. There are no long-term epidemiological studies on burn injuries in adults in Israel.
To identify risk factors for burn injuries and provide a starting point for the establishment of an effective prevention plan.
We analyzed the demographic, etiologic and clinical data of 5000 burn patients admitted to the five major hospitals with burn units in Israel during a 7 year period (1997-2003). Data were obtained from the records of the Israeli National Trauma Registry. The differences between various groups were evaluated using the chi-square test.
Male gender was twice as frequent as female gender in burn patients (68.0% vs. 31.9%), and non-Jewish ethnicity was more common when considering their proportion in the total population (62.3% vs. 36.8%). Second and third-degree burns with body surface areas less than 10% constituted the largest group (around 50%). The largest age group was 0-1 years, constituting 22.2% of the cases. Inhalation injury was uncommon (1.9%). The most common etiologies were hot liquids (45.8%) and open fire (27.5%). Children less than 10 years old were burnt mainly by hot liquids while the main cause of burns for adults > 20 years old was an open flame. The majority of burns occurred at home (58%); around 15% were work related. The mean duration of hospitalization was 13.7 days (SD 17.7); 15.5% were in an intensive care unit with a mean duration of 12.1 days (SD 17.1). Surgical procedures became more common during the period of the study (from 13.4% in 1998 to 26.59% in 2002, average 19.8%). The mortality rate was 4.4%. We found a strong correlation between burn degree and total body surface area and mortality (0.25% mortality for 2nd to 3rd-degree burns with less than 10% TBSA, 5.4% for 2nd to 3rd-degree burns with 20-39% TBSA, and 96.6% for burns > 90% TBSA). The worst prognosis was for those over the age of 70 (mortality rate 35.3%) and the best prognosis was for the 0-1 year group (survival rate 99.6%).
The groups at highest risk were children 0-1 years old, males and non-Jews (the incidence rate among non-Jews was 1.5 times higher than their share in the general population). Those with the highest mortality rate were victims of burns > 90% TBSA and patients older than 70. Most burns occurred at home.
烧伤是一个重大的公共卫生问题，患者在重症监护病房和普通病房的住院时间都很长。在以色列，所有住院受伤病例中约5%为烧伤。以色列尚无关于成人烧伤的长期流行病学研究。
确定烧伤的危险因素，并为制定有效的预防计划提供一个起点。
我们分析了以色列5家设有烧伤科的主要医院在7年期间（1997 - 2003年）收治的5000例烧伤患者的人口统计学、病因学和临床数据。数据来自以色列国家创伤登记处的记录。使用卡方检验评估不同组之间的差异。
烧伤患者中男性的发生率是女性的两倍（68.0%对31.9%），非犹太族裔在总人口中的比例更高（62.3%对36.8%）。体表面积小于10%的二度和三度烧伤患者构成最大群体（约50%）。最大年龄组为0 - 1岁，占病例的22.2%。吸入性损伤不常见（1.9%）。最常见的病因是热液烫伤（45.8%）和明火烧伤（27.5%）。10岁以下儿童主要因热液烫伤，而20岁以上成人烧伤的主要原因是明火。大多数烧伤发生在家中（58%）；约15%与工作相关。平均住院时间为13.7天（标准差17.7）；15.5%的患者入住重症监护病房，平均住院时间为12.1天（标准差17.1）。在研究期间，手术治疗变得更为常见（从1998年的13.4%增至2002年的26.59%，平均为19.8%）。死亡率为4.4%。我们发现烧伤程度和体表面积与死亡率之间存在很强的相关性（体表面积小于10%的二度至三度烧伤死亡率为0.25%，体表面积20 - 39%的二度至三度烧伤死亡率为5.4%，体表面积大于90%的烧伤死亡率为96.6%）。70岁以上患者的预后最差（死亡率35.3%），0 - 1岁组的预后最好（生存率99.6%）。
风险最高的群体是0 - 1岁儿童、男性和非犹太人（非犹太人的发病率比其在总人口中的比例高1.5倍）。死亡率最高的是体表面积大于90%的烧伤患者和70岁以上的患者。大多数烧伤发生在家中。
