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移动房屋火灾中的烧伤——在一家地区烧伤中心的描述性研究

Burns in mobile home fires--descriptive study at a regional burn center.

作者信息

Mullins Robert F, Alarm Badrul, Huq Mian Mohammad Anwarul, Samples Jancie M, Friedman Bruce C, Shaver Joseph R, Brandigi Claus, Hassan Zaheed

机构信息

Joseph M Still Burn Centers, Inc., Augusta, Georgia 30909, USA.

出版信息

J Burn Care Res. 2009 Jul-Aug;30(4):694-9. doi: 10.1097/BCR.0b013e3181abff34.

Abstract

Death from fires and burns are the sixth most common cause of unintentional injury death in the United States. More than (3/4) of burn deaths occurring in the United States are in the home. Mobile home fires carry twice the death rate as other dwellings. The aim of the study was to describe the characteristics of deaths and injuries in mobile home fire admitted in a regional Burn Center and to identify possible risk factors. A cross-sectional retrospective study was carried out among all burn patients admitted to a regional Burn Center between January 2002 and December 2004 (3469 patients). The study included patients who suffered a burn injury from a mobile home fire. The demographic characteristics of the patients, location of mobile home, associated inhalation injury, source of fire, comorbidity of the victims, employment status, insurance status, family history of burns, and outcomes of the treatment were incorporated in a data collection record. There were 65 burn patients in mobile home fires admitted to the Burn Center during the studied period. The average age of the patients was 39 years (ranging from 2 to 81 years, SD=16.06), 77% were male, 67% were white, and 79% were the residents in the suburban areas of Georgia, South Carolina, North Carolina, and Florida. The average TBSA of burns was about 21% (ranging from 1 to 63%, SD=17.66), 63% of the patients had associated inhalation, three inhalation injury only, and 69% patients required ventilator support. The average length of stay per TBSA percentage of burn was 1.01 days (P=0.00), controlling for age, preexisting medical comorbidities, and inhalation injury. About 88% of the patients had preexisting medical comorbid conditions, 74% were smokers, 64% reported as alcoholic, and 72% had at least some form of health insurance coverage. In 40% of the cases, the cause of the fire was unknown, 31% were caused by accidental explosions, such as electric, gasoline, or kerosene appliances, and 29% were due to other causes. About 40% of burns took place between December and February. Among the studied cohorts, 32% were unemployed, 15% were disabled, and 14% did not have any information about their employment status. One in every four patients had a family history of a burn. Eight (12%) died in the hospital during treatment. There was a higher prevalence of inhalation injury and higher case fatality among the burn patients in mobile home fires compared with the statistics of the Burn Center. Observation showed a higher number of smokers and alcoholics among the burn patients. The main sources of fire were from home appliances. Fewer people had health insurance coverage than the national standard and more people suffered from some sort of chronic illness compared with the national morbidity data.

摘要

火灾和烧伤致死是美国非故意伤害死亡的第六大常见原因。在美国,超过四分之三的烧伤死亡发生在家中。移动房屋火灾的死亡率是其他住宅的两倍。本研究的目的是描述一家地区烧伤中心收治的移动房屋火灾伤亡特征,并确定可能的风险因素。对2002年1月至2004年12月期间收治到一家地区烧伤中心的所有烧伤患者(3469例)进行了一项横断面回顾性研究。该研究纳入了因移动房屋火灾而烧伤的患者。患者的人口统计学特征、移动房屋位置、相关吸入性损伤、火源、受害者的合并症、就业状况、保险状况、烧伤家族史以及治疗结果都被纳入数据收集记录中。在研究期间,有65例因移动房屋火灾而烧伤的患者被收治到烧伤中心。患者的平均年龄为39岁(范围为2至81岁,标准差=16.06),77%为男性,67%为白人,79%是佐治亚州、南卡罗来纳州、北卡罗来纳州和佛罗里达州郊区的居民。烧伤的平均总体表面积约为21%(范围为1至63%,标准差=17.66),63%的患者伴有吸入性损伤,3例仅为吸入性损伤,69%的患者需要呼吸机支持。在控制年龄、既往合并症和吸入性损伤的情况下,每烧伤总体表面积百分比的平均住院时间为1.01天(P=0.00)。约88%的患者有既往合并症,74%为吸烟者,64%报告为酗酒者,72%至少有某种形式的医疗保险。在40%的病例中,火灾原因不明,31%是由意外爆炸引起的,如电气、汽油或煤油器具,29%是由其他原因引起的。约40%的烧伤发生在12月至2月之间。在研究队列中,32%失业,15%残疾,14%没有任何就业状况信息。每四名患者中就有一人有烧伤家族史。八名(12%)患者在治疗期间死于医院。与烧伤中心的统计数据相比,移动房屋火灾烧伤患者中吸入性损伤的患病率更高,病死率也更高。观察发现烧伤患者中吸烟者和酗酒者较多。火源主要来自家用电器。与国家标准相比,拥有医疗保险的人数较少,与全国发病率数据相比,患有某种慢性病的人数较多。

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