Matt Sarah E, Shupp Jeffery W, Carter Elizabeth A, Shaw Jesse D, Jordan Marion H
The Burn Center, Department of Surgery, Washington Hospital Center, Washington, DC 20010, USA.
J Burn Care Res. 2012 Sep-Oct;33(5):606-11. doi: 10.1097/BCR.0b013e318241b13d.
Electrical injuries usually represent a small proportion of a burn center's admissions. Although burn size may be small, internal tissue damage is sometimes extensive. This study reviews a single institution's experience with electrical injuries and compares it to the multi-institutional data of the National Burn Repository (NBR). The 2009 NBR and the records of a large urban burn center (single institution) were queried for adult electrical injuries over an 8-year period. Data examined included demographics, %TBSA burn, length of stay (LOS), injury circumstance, and disposition. Multiple linear regression models were created to determine factors related to LOS. One hundred ninety-one single-institution patients and 2837 multi-institution patients met the criteria. Both cohorts were mostly white males approximately 30 years of age and injuries where often work-related. Single-institution patients had a mean injury size of 4% TBSA, while multi-institution patients had 7%. The most common exposure source was domestic wiring for single-institution patients and electrical power plants/lines for multi-institution patients. Single-institution data showed that females had a shorter LOS than males (P < .0001). Single-institution data showed that independent risk factors for an increased LOS were infection, amputation, fasciotomy, and being Hispanic. Independent risk factors for multi-institution patients were being Hispanic and large %TBSA burn. There was no difference in mortality, gender, age, LOS, or intensive care unit LOS between the cohorts. In this analysis, there was no statistical difference between outcomes in the single- or multi-institutional groups. However, injuries reported in the NBR were slightly larger. In both cohorts, an increase in LOS was associated with %TBSA, as expected. Interestingly, Hispanic ethnicity correlated with an increased LOS. Future work will be aimed at understanding this correlation to determine whether it is specific to electrical injury or burns in general.
电击伤在烧伤中心的入院病例中通常占比很小。尽管烧伤面积可能较小，但有时内部组织损伤却很广泛。本研究回顾了一家机构电击伤的治疗经验，并将其与国家烧伤资料库（NBR）的多机构数据进行比较。查询了2009年NBR以及一家大型城市烧伤中心（单一机构）8年间成人电击伤的记录。所检查的数据包括人口统计学资料、烧伤总面积（%TBSA）、住院时间（LOS）、受伤情况及出院处置。建立了多元线性回归模型以确定与住院时间相关的因素。191名单一机构患者和2837名多机构患者符合标准。两个队列的患者大多为30岁左右的白人男性，且受伤常与工作相关。单一机构患者的平均受伤面积为4%TBSA，而多机构患者为7%。单一机构患者最常见的暴露源是家庭布线，多机构患者则是发电厂/电线。单一机构数据显示，女性的住院时间比男性短（P <.0001）。单一机构数据表明，住院时间延长的独立危险因素包括感染、截肢、筋膜切开术以及西班牙裔。多机构患者的独立危险因素是西班牙裔和烧伤总面积大。两组队列在死亡率、性别、年龄、住院时间或重症监护病房住院时间方面无差异。在本分析中，单一机构组和多机构组的结果无统计学差异。然而，NBR报告的损伤面积略大。正如预期的那样，在两个队列中，住院时间的增加都与烧伤总面积相关。有趣的是，西班牙裔与住院时间延长相关。未来的工作将致力于理解这种相关性，以确定它是电击伤特有的还是一般烧伤也存在。
