澳大利亚和新西兰成年人严重烧伤:流行病学和烧伤中心护理。
Severe burns in Australian and New Zealand adults: Epidemiology and burn centre care.
机构信息
Monash University, Department of Epidemiology and Preventive Medicine, Melbourne, Victoria, Australia.
Monash University, Department of Epidemiology and Preventive Medicine, Melbourne, Victoria, Australia; The Victorian Adult Burns Unit, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Surgery, Monash University Central Clinical School, Melbourne, Victoria, Australia.
出版信息
Burns. 2019 Sep;45(6):1456-1461. doi: 10.1016/j.burns.2019.04.006. Epub 2019 Apr 30.
INTRODUCTION
Studies describing the epidemiology of severe burns (>20% total body surface area) in adults are limited despite the extensive associated morbidity and mortality. This study aimed to describe the epidemiology of severe burn injuries admitted to burn centres in Australia and New Zealand.
MATERIALS AND METHODS
Data from the Burns Registry of Australia and New Zealand (BRANZ) were used in this study. Patients were eligible for inclusion if they were admitted between August 2009 and June 2013, were adults (18-years or older), and had burns of 20% total body surface area (TBSA) or greater. Demographics, burn characteristics and in-hospital mortality risk factors were investigated using multivariable Cox proportional hazards analysis.
RESULTS
There were 496 BRANZ registered patients who met the inclusion criteria. Over half of the patients were aged 18-40 years and most were male. The median (IQR) TBSA was 31 (25-47). Most (75%) patients had burns involving <50% TBSA, 58% sustained their burn injury at home, and 86% had sustained flame burns. Leisure activities, working for income and preparing food together accounted for over 48% of the activities undertaken at the time of injury. The in-hospital mortality rate was 17% and the median (IQR) length of stay was 24 (12-44) days. Seventy-two percent were admitted to an intensive care unit (ICU) and 40% of patients had an associated inhalation injury. Alcohol and/or drug involvement was suspected in 25% of cases.
CONCLUSION
This study describes the demographics, burn injury characteristics and in-hospital outcomes of severe burn injuries in adults whilst also identifying key predictors of inpatient mortality. Key findings included the over-representation of young males, intentional self-harm injuries and flame as a cause of burns and highlights high risk groups to help aid in the development of targeted prevention strategies.
简介
尽管严重烧伤(>20%体表面积)相关的发病率和死亡率很高,但描述成人严重烧伤流行病学的研究仍然有限。本研究旨在描述澳大利亚和新西兰烧伤中心收治的严重烧伤患者的流行病学情况。
材料和方法
本研究使用了澳大利亚和新西兰烧伤登记处(BRANZ)的数据。如果患者在 2009 年 8 月至 2013 年 6 月期间入院,年龄在 18 岁或以上,烧伤面积达到或超过 20%体表面积(TBSA),则符合纳入标准。使用多变量 Cox 比例风险分析调查了人口统计学、烧伤特征和住院期间死亡风险因素。
结果
BRANZ 登记的符合纳入标准的患者有 496 名。超过一半的患者年龄在 18-40 岁之间,大多数为男性。TBSA 的中位数(IQR)为 31(25-47)。大多数(75%)患者的烧伤面积<50% TBSA,58%的烧伤发生在家庭中,86%的烧伤为火焰烧伤。休闲活动、为收入工作和准备食物占受伤时所进行活动的 48%以上。住院死亡率为 17%,中位(IQR)住院时间为 24(12-44)天。72%的患者被收入重症监护病房(ICU),40%的患者有吸入性损伤。25%的病例怀疑与酒精和/或药物有关。
结论
本研究描述了成人严重烧伤患者的人口统计学、烧伤损伤特征和住院期间结果,同时确定了住院死亡率的关键预测因素。主要发现包括年轻男性、故意自残和火焰是烧伤的主要原因,这些发现突出了高危人群,有助于制定有针对性的预防策略。