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衰老与烧伤:葡萄牙一家大型烧伤中心的五年回顾性研究。

Aging and burn: a five-year retrospective study in a major burn centre in Portugal.

作者信息

Caetano P, Brandão C, Campos I, Tão J, Laíns J, Cabral L

机构信息

Rehabilitation Medicine Centre - Rovisco Pais, Tocha, Portugal.

Department of Plastic Surgery and Burns Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.

出版信息

Ann Burns Fire Disasters. 2018 Sep 30;31(3):163-167.

Abstract

Aging is an important factor contributing decisively to the clinical outcome of burn patients. The aim of this study was to assess the characteristics of patients admitted to a Burn Unit and determine the impact of aging on mortality. A retrospective analysis of patients successively admitted to a major burn centre in Portugal from 1/1/2012 to 31/12/2016 was conducted. They were divided into 2 groups: "elderly" (≥65 years) and "non-elderly" (<65 years). A total of 736 patients were included, 324 of them classified as elderly with a mean age of 78.12±7.14 years. Most of the patients in the elderly group were female (59.6%), in contrast to the non-elderly group (35%; p<0.001). The elderly patients had a higher mean length of hospital stay (20.14±18.46 days; p=0.011). Most of the burns were caused by fire (58.3%) and scalding (36.1%) and mainly after home accidents. Elderly patients showed a higher mean of burn severity index (7.26; p<0.001) and 6.8% needed an amputation. Mortality rate was significantly higher in the elderly group (11.7%; p=0.001). Age (p<0.001; OR=1.169), a higher total burn surface area (p<0.001; OR=1.081), full-thickness burns (p=0.005; OR=11.985) and the need for mechanical ventilation (p<0.001; OR=16.856) were associated with a higher mortality risk and reached statistical significance after multivariate analysis. The functional and vital prognosis of patients admitted to a burn centre is affected by multiple factors. This study showed that age, higher TBSA, full-thickness burns and need for mechanical ventilation seem to increase the risk of mortality.

摘要

衰老作为一个重要因素,对烧伤患者的临床结局有着决定性影响。本研究旨在评估烧伤科收治患者的特征,并确定衰老对死亡率的影响。对2012年1月1日至2016年12月31日期间连续入住葡萄牙一家大型烧伤中心的患者进行了回顾性分析。他们被分为两组:“老年组”(≥65岁)和“非老年组”(<65岁)。共纳入736例患者,其中324例被归类为老年患者,平均年龄为78.12±7.14岁。老年组大多数患者为女性(59.6%),而非老年组为35%(p<0.001)。老年患者的平均住院时间更长(20.14±18.46天;p=0.011)。大多数烧伤是由火灾(58.3%)和烫伤(36.1%)引起的,主要发生在家中事故后。老年患者的烧伤严重程度指数平均较高(7.26;p<0.001),6.8%的患者需要截肢。老年组的死亡率显著更高(11.7%;p=0.001)。年龄(p<0.001;OR=1.169)、较高的烧伤总面积(p<0.001;OR=1.081)、全层烧伤(p=0.005;OR=11.985)以及需要机械通气(p<0.001;OR=16.856)与较高的死亡风险相关,经多因素分析后具有统计学意义。烧伤中心收治患者的功能和生命预后受多种因素影响。本研究表明,年龄、较高的烧伤总面积、全层烧伤以及需要机械通气似乎会增加死亡风险。

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