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老年人烧伤的结局:伯明翰烧伤中心的修订估计数

Outcomes of burns in the elderly: revised estimates from the Birmingham Burn Centre.

作者信息

Wearn Christopher, Hardwicke Joseph, Kitsios Andreas, Siddons Victoria, Nightingale Peter, Moiemen Naiem

机构信息

Healing Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.

Healing Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.

出版信息

Burns. 2015 Sep;41(6):1161-8. doi: 10.1016/j.burns.2015.04.008. Epub 2015 May 14.

Abstract

Outcomes after burn have continued to improve over the last 70 years in all age groups including the elderly. However, concerns have been raised that survival gains have not been to the same magnitude in elderly patients compared to younger age groups. The aims of this study were to analyze the recent outcomes of elderly burn injured patients admitted to the Birmingham Burn Centre, compare data with a historical cohort and published data from other burn centres worldwide. A retrospective review was conducted of all patients ≥65 years of age, admitted to our centre with cutaneous burns, between 2004 and 2012. Data was compared to a previously published historical cohort (1999-2003). 228 patients were included. The observed mortality for the study group was 14.9%. The median age of the study group was 79 years, the male to female ratio was 1:1 and median Total Body Surface Area (TBSA) burned was 5%. The incidence of inhalation injury was 13%. Median length of stay per TBSA burned for survivors was 2.4 days/% TBSA. Mortality has improved in all burn size groups, but differences were highly statistically significant in the medium burn size group (10-20% TBSA, p≤0.001). Burn outcomes in the elderly have improved over the last decade. This reduction has been impacted by a reduction in overall injury severity but is also likely due to general improvements in burn care, improved infrastructure, implementation of clinical guidelines and increased multi-disciplinary support, including Geriatric physicians.

摘要

在过去70年里,包括老年人在内的所有年龄组烧伤后的预后情况都在持续改善。然而,有人担心老年患者的生存获益与年轻年龄组相比幅度不同。本研究的目的是分析入住伯明翰烧伤中心的老年烧伤患者的近期预后,将数据与历史队列以及全球其他烧伤中心公布的数据进行比较。对2004年至2012年间入住我们中心的所有年龄≥65岁的皮肤烧伤患者进行了回顾性研究。将数据与之前发表的历史队列(1999 - 2003年)进行比较。共纳入228例患者。研究组的观察到的死亡率为14.9%。研究组的中位年龄为79岁,男女比例为1:1,中位烧伤总面积(TBSA)为5%。吸入性损伤的发生率为13%。幸存者每%TBSA烧伤的中位住院时间为2.4天。所有烧伤面积组的死亡率均有所改善,但中度烧伤面积组(10 - 20%TBSA,p≤0.001)差异具有高度统计学意义。在过去十年中,老年患者的烧伤预后有所改善。这种下降受到总体损伤严重程度降低的影响,但也可能归因于烧伤护理的总体改善、基础设施的改善、临床指南的实施以及包括老年病医生在内的多学科支持的增加。

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