Abdelrahman Islam, Elmasry Moustafa, Fredrikson Mats, Steinvall Ingrid
Plastic Surgery Unit, Surgery Department, Suez Canal University, Ismailia, Egypt; Department of Hand Surgery, Plastic Surgery and Burns, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Plastic Surgery Unit, Surgery Department, Suez Canal University, Ismailia, Egypt; Department of Hand Surgery, Plastic Surgery and Burns, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Burns. 2018 Aug;44(5):1159-1166. doi: 10.1016/j.burns.2018.02.001. Epub 2018 Feb 21.
The Linköping burn score has been used for two decades to calculate the cost to the hospital of each burned patient. Our aim was to validate the Burn Score in a dedicated Burn Centre by analysing the associations with burn-specific factors: percentage of total body surface area burned (TBSA%), cause of injury, patients referred from other (non-specialist) centres, and survival, to find out which of these factors resulted in higher scores. Our second aim was to analyse the variation in scores of each category of care (surveillance, respiration, circulation, wound care, mobilisation, laboratory tests, infusions, and operation). We made a retrospective analysis of all burned patients admitted during the period 2000-15. Multivariable regression models were used to analyse predictive factors for an increased daily burn score, the cumulative burn score (the sum of the daily burn scores for each patient) and the total burn score (total sum of burn scores for the whole group throughout the study period) in addition to sub-analysis of the different categories of care that make up the burn score. We retrieved 22301 daily recordings for inpatients. Mobilisation and care of the wound accounted for more than half of the total burn score during the study. Increased TBSA% and age over 45 years were associated with increased cumulative (model R 0.43, p<0.001) and daily (model R 0.61, p<0.001) burn scores. Patients who died had higher daily burn scores, while the cumulative burn score decreased with shorter duration of hospital stay (p<0.001). To our knowledge this is the first long term analysis and validation of a system for scoring burn interventions in patients with burns that explores its association with the factors important for outcome. Calculations of costs are based on the score, and it provides an indicator of the nurses' workload. It also gives important information about the different dimensions of the care provided from thorough investigation of the scores for each category.
林雪平烧伤评分已被使用了二十年，用于计算每位烧伤患者给医院带来的成本。我们的目的是通过分析与烧伤特定因素的关联，在一个专门的烧伤中心验证烧伤评分：烧伤总面积百分比（TBSA%）、受伤原因、从其他（非专科）中心转诊来的患者以及生存率，以找出哪些因素会导致更高的评分。我们的第二个目的是分析每类护理（监测、呼吸、循环、伤口护理、活动、实验室检查、输液和手术）评分的变化。我们对2000年至2015年期间收治的所有烧伤患者进行了回顾性分析。除了对构成烧伤评分的不同护理类别进行子分析外，还使用多变量回归模型分析每日烧伤评分增加、累积烧伤评分（每位患者每日烧伤评分之和）和总烧伤评分（整个研究期间该组患者烧伤评分的总和）的预测因素。我们检索到了22301份住院患者的每日记录。在研究期间，活动和伤口护理占总烧伤评分的一半以上。TBSA%增加和年龄超过45岁与累积烧伤评分增加（模型R 0.43，p<0.001）和每日烧伤评分增加（模型R 0.61，p<0.001）相关。死亡患者的每日烧伤评分更高，而累积烧伤评分随着住院时间缩短而降低（p<0.001）。据我们所知，这是首次对烧伤患者烧伤干预评分系统进行长期分析和验证，该系统探讨了其与对预后重要因素的关联。成本计算基于该评分，它提供了护士工作量的指标。通过对每类评分的深入研究，它还给出了所提供护理不同维度的重要信息。
