Department of Plastic and Reconstructive Surgery, Merheim-Hospital University of Witten/Herdecke, 51109 Cologne, Germany.
Burns. 2013 Feb;39(1):49-54. doi: 10.1016/j.burns.2012.05.003. Epub 2012 Jun 4.
To analyze trends in incidence and treatment of thermal injuries over the last two decades.
We retrospectively reviewed our local single center database of patients with thermal injuries admitted to the burn intensive care unit (BICU) of the Cologne-Merheim Medical Center (University Hospital of Witten/Herdecke). The cohort was divided into two groups according to the decade of admission and the epidemiology and clinical course of the patient sample admitted during the period 1991-2000 (n=911) was compared to that of 2001-2010 (n=695).
The following variables were significantly different in the bivariate analysis: mean age (39.8 years vs. 44.0 years), burn size of total body surface area (23.2% vs. 18.0%) and size of 3rd degree burns (9.6% vs. 14.9%). The incidence of inhalation injury was significantly lower in the last decade (33.3% vs. 13.7%) and was associated with a shorter duration of mechanical ventilation (10.8 days vs. 8.5 days). The ABSI-score as an indicator of burn severity declined in the second period (6.3 vs. 6.0) contributing partially to the decline of BICU length of stay (19.1 days vs. 18.8 days) and to the mortality rate decrease (18.6% vs. 15.0%).
The severity of burn injuries during the last two decades declined, probably reflecting the success of prevention campaigns. Concerning mortality, the chance of dying for a given severity of injury has decreased.
分析过去二十年中热烧伤发病率和治疗趋势。
我们回顾性分析了我们当地的单一中心数据库，该数据库包含了在科隆-梅尔海姆医学中心（维滕/赫德克大学医院）烧伤重症监护病房（BICU）收治的热烧伤患者。该队列根据入院的十年分为两组，比较了 1991 年至 2000 年（n=911）期间入院患者的流行病学和临床过程与 2001 年至 2010 年（n=695）期间入院患者的流行病学和临床过程。
在单变量分析中，以下变量存在显著差异：平均年龄（39.8 岁 vs. 44.0 岁）、总体表面积烧伤面积（23.2% vs. 18.0%）和三度烧伤面积（9.6% vs. 14.9%）。在过去十年中，吸入性损伤的发生率显著降低（33.3% vs. 13.7%），与机械通气时间缩短相关（10.8 天 vs. 8.5 天）。烧伤严重程度的 ABSI 评分在第二阶段下降（6.3 分 vs. 6.0 分），这在一定程度上导致 BICU 住院时间缩短（19.1 天 vs. 18.8 天）和死亡率降低（18.6% vs. 15.0%）。
在过去二十年中，烧伤严重程度有所下降，这可能反映了预防运动的成功。就死亡率而言，给定严重程度的烧伤死亡率降低。
