Mahar Patrick, Wasiak Jason, Bailey Michael, Cleland Heather
Victorian Adult Burns Service, The Alfred Hospital, Commercial Rd., Prahran 3004, Australia.
Burns. 2008 Aug;34(5):629-36. doi: 10.1016/j.burns.2007.09.006. Epub 2008 Jan 22.
The purpose of this retrospective study was to provide basic probabilistic predictors of mortality to assist in determining appropriate therapeutic aggression in elderly burns population.
Eighty patients over the age of 70 years were admitted to the Victorian Adult Burns Service in Melbourne, Australia, over a period of 4 years. Retrospective data was analysed, taking into account patient demographics, type, site, depth and area of burn, presence of inhalation injury, number of co-morbidities, survival time and the number of operations performed, withdrawal of care and implementation of comfort measures only.
Comparing survivors and non-survivors, significant differences were found between age, percentage total burn surface area (TBSA%), percentage full thickness surface area (FTSA%), presence of inhalation injury, site of burn and number of operations. The number of co-morbidities and gender were not significant to outcome. FTSA%, presence of inhalation injury, site of burn, age and number of operations were all significantly related to survival time. When patients who obtained comfort care were excluded from analysis, age and the number of operations were not considered to be significantly related to mortality.
This study indicates that TBSA%, FTSA%, inhalation injury and age are significant predictors of death in the elderly burns population, although only the first three remain significant when patients who receive comfort care measures only are excluded.
这项回顾性研究的目的是提供死亡率的基本概率预测指标,以协助确定老年烧伤患者适当的积极治疗方案。
在4年期间,80名70岁以上的患者被收治到澳大利亚墨尔本的维多利亚成人烧伤服务中心。对回顾性数据进行了分析,考虑了患者的人口统计学特征、烧伤类型、部位、深度和面积、吸入性损伤的存在、合并症数量、生存时间、手术次数、仅实施的护理撤离和舒适措施。
比较幸存者和非幸存者,发现年龄、烧伤总面积百分比(TBSA%)、全层面积百分比(FTSA%)、吸入性损伤的存在、烧伤部位和手术次数存在显著差异。合并症数量和性别对结果无显著影响。FTSA%、吸入性损伤的存在、烧伤部位、年龄和手术次数均与生存时间显著相关。当将接受舒适护理的患者排除在分析之外时,年龄和手术次数与死亡率无显著相关性。
本研究表明,TBSA%、FTSA%、吸入性损伤和年龄是老年烧伤患者死亡的重要预测指标,尽管仅排除仅接受舒适护理措施的患者时,前三项指标仍具有显著性。