Angulo Martín, Aramendi Ignacio, Cabrera Julio, Burghi Gastón
Centro Nacional de Quemados, Cátedra de Medicina Intensiva, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
Rev Bras Ter Intensiva. 2020 Mar;32(1):43-48. doi: 10.5935/0103-507x.20200008. Epub 2020 May 8.
To determine the independent risk factors associated with mortality in adult burn patients.
This was a retrospective, observational study performed at the Centro Nacional de Queimados do Uruguai. All patients with skin burns admitted to the unit since its opening on July 1, 1995 through December 31, 2018 were included. The demographic data, burn profiles, length of stay, mechanical ventilation duration and hospital mortality were studied. A multivariate logistic regression was used to identify the risk factors for mortality. The standardized mortality ratio was calculated by dividing the number of observed deaths by the number of expected deaths (according to the Abbreviated Burn Severity Index).
During the study period, 3,132 patients were included. The median total body surface area burned was 10% (3%-22%). The Abbreviated Burn Severity Index was 6 (4 - 7). Invasive mechanical ventilation was required in 60% of the patients for a median duration of 6 (3 - 16) days. The median length of stay in the unit was 17 (7 - 32) days. The global mortality was 19.9%. Crude mortality and standardized mortality ratio decreased from 1995 through 2018. The global standardized mortality ratio was 0.99. A need for mechanical ventilation (OR 8.80; 95%CI 5.68 - 13.62), older age (OR 1.07 per year; 95%CI 1.06 - 1.09), total body surface area burned (OR 1.05 per 1%; 95%CI 1.03 - 1.08) and extension of third-degree burns (OR 1.05 per 1%; 95%CI 1.03 - 1.07) were independent risk factors for mortality.
The need for mechanical ventilation, older age and burn extension were independent risk factors for mortality in the burned adult Uruguayan population.
确定成年烧伤患者死亡的独立危险因素。
这是一项在乌拉圭国家烧伤中心开展的回顾性观察性研究。纳入了自1995年7月1日该科室开业至2018年12月31日期间收治的所有皮肤烧伤患者。研究了人口统计学数据、烧伤情况、住院时间、机械通气时长和医院死亡率。采用多因素逻辑回归分析确定死亡的危险因素。标准化死亡率通过将观察到的死亡人数除以预期死亡人数（根据简化烧伤严重程度指数）计算得出。
研究期间共纳入3132例患者。烧伤总面积中位数为10%（3%-22%）。简化烧伤严重程度指数为6（4-7）。60%的患者需要有创机械通气，中位时长为6（3-16）天。在该科室的中位住院时间为17（7-32）天。总体死亡率为19.9%。1995年至2018年期间，粗死亡率和标准化死亡率均下降。总体标准化死亡率为0.99。需要机械通气（比值比8.80；95%置信区间5.68-13.62）、年龄较大（每年比值比1.07；95%置信区间1.06-1.09）、烧伤总面积（每1%比值比1.05；95%置信区间1.03-1.08）和三度烧伤范围（每1%比值比1.05；95%置信区间1.03-1.07）是死亡的独立危险因素。
对于乌拉圭成年烧伤人群，需要机械通气、年龄较大和烧伤范围是死亡的独立危险因素。
