Stewart Ian J, Sosnov Jonathan A, Snow Brian D, Batou Augen, Howard Jeffrey T, Janak Jud C, Bollinger Mary, Chung Kevin K
David Grant USAF Medical Center, Clinical Investigation Facility, 101 Bodin Circle, Travis AFB, CA 94535, United States; Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, United States.
Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, United States; San Antonio Military Medical Center, 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78219, United States.
Burns. 2017 Mar;43(2):290-296. doi: 10.1016/j.burns.2016.10.005. Epub 2016 Oct 28.
The long-term health effects of burn are poorly understood. We sought to evaluate the relationship between burn and the subsequent development of hypertension.
Retrospective cohort study of patients admitted to our burn center from 2003 to 2010. Data collected included demographic variables, burn size, injury severity score, presence of inhalation injury, serum creatinine, need for renal replacement therapy, as well as days spent in the hospital, in the intensive care unit and on mechanical ventilation. Data for the subsequent diagnosis of hypertension was obtained from medical records. Cox proportional hazard regression models were performed to determine what factors were associated with hypertension.
Of the 711 patients identified, 670 were included for analysis after exclusions. After adjustment, only age (HR 1.06 per one year increase, 95% confidence interval 1.03-1.08; p<0.001), percentage of total body surface area burned (HR 1.11 per 5% increase, 95% confidence interval 1.04-1.19; p=0.002) and acute kidney injury (HR 1.68, 95% confidence interval 1.05-2.69; p=0.03) were associated with hypertension.
Burn size is independently associated with the subsequent risk of hypertension in combat casualties. Clinical support for primary prevention techniques to reduce the incidence of hypertension specific to burn patients may be warranted.
烧伤对长期健康的影响尚不清楚。我们试图评估烧伤与随后发生高血压之间的关系。
对2003年至2010年入住我们烧伤中心的患者进行回顾性队列研究。收集的数据包括人口统计学变量、烧伤面积、损伤严重程度评分、吸入性损伤的存在、血清肌酐、肾脏替代治疗的需求，以及住院天数、重症监护病房住院天数和机械通气天数。后续高血压诊断的数据来自病历。进行Cox比例风险回归模型以确定哪些因素与高血压相关。
在确定的711例患者中，排除后670例纳入分析。调整后，只有年龄（每增加一岁HR为1.06，95%置信区间为1.03-1.08；p<0.001）、烧伤总面积百分比（每增加5%HR为1.11，95%置信区间为1.04-1.19；p=0.002）和急性肾损伤（HR为1.68，95%置信区间为1.05-2.69；p=0.03）与高血压相关。
烧伤面积与战斗伤员随后发生高血压的风险独立相关。可能需要对旨在降低烧伤患者特有的高血压发病率的一级预防技术提供临床支持。
