Shahabi Shahmiri Shahab, Kolahdouzan Mohsen, Omrani Ara, Khazaei Mehdi, Salehi Hamid, Motavalian Abbas, Mohammadi Mofrad Rastin, Rezaei Mohammad Taghi, Hemasian Helia
Department of General Surgery, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran.
Department of Thoracic Surgery, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran.
Bull Emerg Trauma. 2017 Jul;5(3):184-189.
To investigate the determinants of mortality and the lethal area 50 (LA50) in large series of Iranian burn patients admitted to a single burn center.
This cross-sectional study was conducted in Shahid Motahari burn center of Tehran, Iran during a 1-year period from 2011 to 2012. We included all the burn patients who were admitted to our center during the study period. Those with incomplete medical records and those referred to other centers were excluded from the study. The medical records of the included patients were reviewed and the demographic, clinical, laboratory and outcome measures were recorded. The mortality rate was recorded and the determinants of LA50 were analyzed in a univariate and stepwise multivariate model.
Overall we included a total number of 1200 subjects with mean age of 30.8 ±18 years. There were 907 (75.6%) men and 293 (24.4%) women among the patients. The total LA50 was 55.5% (95% CI: 52.98%-58.3 %). There was a significant difference between age group >61 years and two 11-20 and 21-30 groups regarding LA50. The advanced age (<0.001), female gender (=0.002), inhalational injury (<0.001) and burn extension determined by TBSA% (<0.001) were significantly associated with mortality. In addition, male gender (=0.087), flame (=0.156), scald (=0.088) and chemical injuries (=0.071) were not associated with mortality.
The LA50 determine din our study is still much lower than that reported in developed countries, as a result, the quality of medical care is lower. Female gender, age, inhalational injury and extension of burn determined by TBSA% were found to be the independent risk factors of mortality in burn patients in our series.
调查入住单一烧伤中心的大量伊朗烧伤患者的死亡率决定因素及半数致死面积（LA50）。
本横断面研究于2011年至2012年期间在伊朗德黑兰的沙希德·莫塔哈里烧伤中心进行。我们纳入了研究期间入住本中心的所有烧伤患者。医疗记录不完整的患者以及转诊至其他中心的患者被排除在研究之外。对纳入患者的医疗记录进行审查，并记录人口统计学、临床、实验室和结局指标。记录死亡率，并在单变量和逐步多变量模型中分析LA50的决定因素。
我们总共纳入了1200名受试者，平均年龄为30.8±18岁。患者中男性907名（75.6%），女性293名（24.4%）。总LA50为55.5%（95%置信区间：52.98%-58.3%）。在LA50方面，年龄>61岁组与11-20岁和21-30岁两个组之间存在显著差异。高龄（<0.001）、女性性别（=0.002）、吸入性损伤（<0.001）和由总体表面积百分比（TBSA%）确定的烧伤范围（<0.001）与死亡率显著相关。此外，男性性别（=0.087）、火焰烧伤（=0.156）、烫伤（=0.088）和化学烧伤（=0.071）与死亡率无关。
我们研究中确定的LA50仍远低于发达国家报告的水平，因此，医疗护理质量较低。在我们的系列研究中，女性性别、年龄、吸入性损伤和由TBSA%确定的烧伤范围是烧伤患者死亡的独立危险因素。
