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烧伤相关死亡病例死前临床诊断与死后检查结果的比较。

Comparison of antemortem clinical diagnosis and postmortem findings in burn-related deaths.

作者信息

Tuğcu Harun, Zor Fatih, Toygar Mehmet, Balandız Hüseyin

机构信息

Department of Forensic Medicine, Gulhane Military Medical Academy, Ankara, Turkey.

Department of Plastic, Reconstructive and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2015 Dec;21(6):491-5. doi: 10.5505/tjtes.2015.36604.

Abstract

BACKGROUND

Burn injuries are an important public health problem resulting in high morbidity and mortality. Mortality in burn patients is associated with age, the extent of the burn surface, and the presence of concurrent chronic diseases. Studies have revealed differences between antemortem clinical diagnoses and postmortem findings in burn-related deaths.

METHODS

In the present study, postmortem examination reports and autopsy reports issued by the Department of Forensic Medicine in Gülhane Military Medical Academy between 1 January 1994 and 30 May 2013 were retrospectively reviewed together with patient charts in an attempt to compare postmortem findings and antemortem clinical findings in burn-related deaths.

RESULTS

In a period of approximately 20 years, thirty-one (6.9%) of the deaths among 450 cases were burn-related. Of the injuries, 90.3% were caused by flame burns. Mean burn percentage was 70.52%, and the survival of these cases was found to decrease significantly with increasing burn percentage (r=-0.491, p=0.005). According to autopsy findings, pneumonia was the most frequently overlooked antemortem clinical diagnosis, and mortality was associated with systemic organ failures.

CONCLUSION

Burn-related deaths are an important cause of mortality among soldiers. We believe that postmortem findings revealed by autopsies could significantly contribute to the treatment of burn cases, and that interdisciplinary data sharing would be important in this respect.

摘要

背景

烧伤是一个重要的公共卫生问题,会导致高发病率和死亡率。烧伤患者的死亡率与年龄、烧伤面积以及是否存在并发慢性病有关。研究显示,在烧伤相关死亡病例中,生前临床诊断与死后检查结果存在差异。

方法

在本研究中,回顾性分析了1994年1月1日至2013年5月30日期间盖勒哈内军事医学院法医学系出具的尸体检查报告和尸检报告,并结合患者病历,以比较烧伤相关死亡病例的死后检查结果和生前临床检查结果。

结果

在大约20年的时间里,450例死亡病例中有31例(6.9%)与烧伤相关。在这些损伤中,90.3%是由火焰烧伤引起的。平均烧伤百分比为70.52%,并且发现这些病例的生存率随着烧伤百分比的增加而显著下降(r=-0.491,p=0.005)。根据尸检结果,肺炎是生前最常被漏诊的临床诊断,死亡率与全身器官衰竭有关。

结论

烧伤相关死亡是士兵死亡的一个重要原因。我们认为,尸检揭示的死后检查结果可为烧伤病例的治疗做出重大贡献,并且在这方面跨学科的数据共享将很重要。

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