Yen Cheng-I, Chiou Meng-Jiun, Kuo Chang-Fu, Liao Han-Tsung
Division of General Plastic Surgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Burns. 2018 Sep;44(6):1591-1601. doi: 10.1016/j.burns.2018.02.030. Epub 2018 Apr 7.
Burns are not only major personal catastrophic events but also constitute a national health problem due to its associated morbidity, rehabilitation, mortality and high cost medical services. Advances in care and treatment have increased survival from major burn injury. However, information on the epidemiology and risk factors of burn mortality in Taiwan is limited. The study aim was to determine the nationwide epidemiological characteristics, trends, and mortality risk factors of burn inpatients in Taiwan.
This nationwide population-based study evaluated data retrieved from the Taiwan National Health Insurance database. Patients hospitalized for burns (ICD-9-CM codes 940-949) between 2003 and 2013 were identified from hospitalization records.
A total of 73,774 patients were included. The data showed increases in age, revised Baux score, and Charlson Comorbidity Index during the study period, but it was also accompanied by a continuing decrease in burn incidence and a significant shortening of the length of hospital stay. The average in-hospital mortality was 17.5/1000 in 2003 and 12.2/1000 in 2013 but did not showed significant change. Male gender, older age, higher Charlson Comorbidity Index, presence of inhalation injury, large total burn surface area (TBSA), and higher revised Baux score were significant predictors of mortality.
Population-based burn epidemiology data demonstrated ongoing improvement in hospital care during the past decade. Male gender, older age, higher Charlson Comorbidity Index, presence of inhalation injury, large TBSA, and higher revised Baux score were significant predictors of mortality.
烧伤不仅是重大的个人灾难性事件，而且因其相关的发病率、康复情况、死亡率和高昂的医疗服务成本，构成了一个国家性的健康问题。护理和治疗方面的进展提高了严重烧伤患者的存活率。然而，台湾地区烧伤死亡率的流行病学和风险因素信息有限。本研究的目的是确定台湾地区烧伤住院患者的全国性流行病学特征、趋势和死亡风险因素。
这项基于全国人口的研究评估了从台湾全民健康保险数据库中检索到的数据。通过住院记录确定2003年至2013年间因烧伤住院（国际疾病分类第九版临床修正版编码940 - 949）的患者。
共纳入73774例患者。数据显示，在研究期间，患者年龄、修正后的博克斯评分和查尔森合并症指数有所增加，但同时烧伤发病率持续下降，住院时间显著缩短。2003年的平均住院死亡率为17.5/1000，2013年为12.2/1000，但未显示出显著变化。男性、年龄较大、查尔森合并症指数较高、存在吸入性损伤、烧伤总面积（TBSA）较大以及修正后的博克斯评分较高是死亡率的显著预测因素。
基于人群的烧伤流行病学数据表明，过去十年间医院护理水平不断提高。男性、年龄较大、查尔森合并症指数较高、存在吸入性损伤、TBSA较大以及修正后的博克斯评分较高是死亡率的显著预测因素。
