Bartley Colleen N, Atwell Kenisha, Purcell Laura, Cairns Bruce, Charles Anthony
Department of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, Chapel Hill, NC, USA.
J Burn Care Res. 2019 Jun 21;40(4):430-436. doi: 10.1093/jbcr/irz034.
Amputation following burn injury is rare. Previous studies describe the risk of amputation after electrical burn injuries. Therefore, we describe the distribution of amputations and evaluate risk factors for amputation following burn injury at a large regional burn center. We conducted a retrospective analysis of patients ≥17 years admitted from January 2002 to December 2015. Patients who did and did not undergo an amputation procedure were compared. A multivariate logistic regression model was used to determine the risk factors for amputation. Amputations were further categorized by extremity location and type (major, minor) for comparison. Of the 8313 patients included for analysis, 1.4% had at least one amputation (n = 119). Amputees were older (46.7 ± 17.4 years) than nonamputees (42.6 ± 16.8 years; P = .009). The majority of amputees were white (47.9%) followed by black (39.5%) when compared with nonamputees (white: 57.1%, black: 27.3%; P = .012). The most common burn etiology for amputees was flame (41.2%) followed by electrical (23.5%) and other (21.9%). Black race (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.22-4.30; P = .010), electric (OR: 13.54; 95% CI: 6.23-29.45; P < .001) and increased %TBSA (OR: 1.03; 95% CI: 1.02-1.05; P < .001) were associated with amputation. Burn etiology, the presence of preexisting comorbidities, black race, and increased %TBSA increase the odds of post burn injury. The role of race on the risk of amputation requires further study.
烧伤后截肢情况罕见。既往研究描述了电烧伤后截肢的风险。因此，我们描述了截肢的分布情况，并评估了一家大型区域烧伤中心烧伤后截肢的危险因素。我们对2002年1月至2015年12月收治的≥17岁患者进行了回顾性分析。对接受和未接受截肢手术的患者进行了比较。使用多因素逻辑回归模型确定截肢的危险因素。截肢进一步按肢体部位和类型（主要、次要）分类以进行比较。在纳入分析的8313例患者中，1.4%至少进行了一次截肢（n = 119）。截肢患者的年龄（46.7±17.4岁）大于未截肢患者（42.6±16.8岁；P = 0.009）。与未截肢患者相比（白人：57.1%，黑人：27.3%；P = 0.012），大多数截肢患者为白人（47.9%），其次是黑人（39.5%）。截肢患者最常见的烧伤病因是火焰烧伤（41.2%），其次是电烧伤（23.5%）和其他烧伤（21.9%）。黑人种族（比值比[OR]：2.29；95%置信区间[CI]：1.22 - 4.30；P = 0.010）、电烧伤（OR：13.54；95% CI：6.23 - 29.45；P < 0.001）和烧伤总面积百分比增加（OR：1.03；95% CI：1.02 - 1.05；P < 0.001）与截肢相关。烧伤病因、既往合并症的存在、黑人种族和烧伤总面积百分比增加会增加烧伤后截肢的几率。种族在截肢风险中的作用需要进一步研究。
