Ganesamoni Sivaram, Kate Vikram, Sadasivan Jagdish
Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantari Nagar, Puducherry 605006, India.
Burns. 2010 May;36(3):422-9. doi: 10.1016/j.burns.2009.06.212. Epub 2009 Sep 25.
The epidemiological pattern of burns varies widely in different parts of the world. To suggest effective preventive measures, an insight into the pattern of injury is desirable. However, data on burn victims and outcome is limited from this part of the world.
This study was conducted in the Department of Surgery, from April 2006 to April 2007. All consecutive patients with major burns admitted for in-hospital treatment during the study period were included in the study. The data collected included age, gender, cause and mode of burns, presence or absence of inhalational injury, facial burns, time delay from burn injury to admission in the hospital, burns depth, total body surface area distribution of burns, associated injuries and co-morbid illness, microbiological profile and outcome. Inhalational injury was assessed by clinical examination as bronchoscopy was not available.
A total of 222 consecutive patients admitted for in-hospital treatment of burn injury were included in the study. 177 patients were adults and 45 were <13 years of age. The female:male ratio was 1.7:1. In adults, 52.5% of burns were due to non-intentional injury and 43.9% were due to self-immolation. In patients <13 years of age, 95.6% of cases were due to non-intentional injury. The mean TBSA was 48.75% and 30.18% of patients had predominantly deep burns. The overall mortality was 60.8%. The predominant organisms colonizing the burn wound were Pseudomonas aeruginosa (81.1%) followed by Acinetobacter species and MRSA. Multivariate logistic regression analysis of factors predicting survival in patients with burn injury showed that TBSA>30%, age>20 years, female gender and presence of facial injury were statistically significant as predictors of risk of death.
In patients with burns, total body surface area involvement more than 30%, age more than 20 years, female gender and presence of facial injury are statistically significant, as predictors of poor outcome and risk of death. The strongest association was seen with facial injury, which increased the risk of death by fourfold.
烧伤的流行病学模式在世界不同地区差异很大。为了提出有效的预防措施,深入了解损伤模式是很有必要的。然而,来自世界这一地区的烧伤患者及其预后的数据有限。
本研究于2006年4月至2007年4月在外科进行。研究纳入了研究期间所有因严重烧伤入院接受住院治疗的连续患者。收集的数据包括年龄、性别、烧伤原因和方式、是否存在吸入性损伤、面部烧伤、从烧伤到入院的时间延迟、烧伤深度、烧伤的总体表面积分布、相关损伤和合并疾病、微生物学特征及预后。由于无法进行支气管镜检查,吸入性损伤通过临床检查进行评估。
本研究共纳入222例因烧伤入院接受住院治疗的连续患者。177例为成年人,45例年龄小于13岁。女性与男性比例为1.7:1。在成年人中,52.5% 的烧伤是由于非故意伤害,43.9% 是由于自焚。在年龄小于13岁的患者中,95.6% 的病例是由于非故意伤害。平均总体表面积为48.75%,30.18% 的患者主要为深度烧伤。总体死亡率为60.8%。烧伤创面主要定植的微生物是铜绿假单胞菌(81.1%),其次是不动杆菌属和耐甲氧西林金黄色葡萄球菌。对烧伤患者生存预测因素的多因素逻辑回归分析表明,总体表面积>30%、年龄>20岁、女性性别和面部损伤的存在作为死亡风险的预测因素具有统计学意义。
在烧伤患者中,总体表面积受累超过30%、年龄超过20岁、女性性别和面部损伤的存在作为预后不良和死亡风险的预测因素具有统计学意义。与面部损伤的关联最为强烈,面部损伤使死亡风险增加了四倍。