University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
Burns. 2021 Feb;47(1):78-83. doi: 10.1016/j.burns.2020.04.029. Epub 2020 May 8.
Trauma is the leading cause of mortality in children. Burn injury involves intensive resources, especially in pediatric patients. We hypothesized that among pediatric trauma patients, combined burn-trauma (BT) patients have increased length of stay (LOS) and mortality compared to trauma-only (T) patients.
The Pediatric Trauma Quality Improvement Program (2014-2016) was queried and BT patients were 1:2 propensity-score-matched to T patients based on age, gender, hypotension on admission, injury type and severity.
93 BT patients were matched to 186 T patients. There were no differences in matched characteristics. BT patients had a longer median LOS (4 vs 2 days, p<0.001) with no difference in mortality (1.1% vs 1.1%, p=1.00), intensive care unit (ICU) LOS (3 vs 3 days, p=0.55), or complications including decubitus ulcer (0% vs 1.1%, p=0.32), deep vein thrombosis (0% vs 0.5%, p=0.48), extremity compartment syndrome (1.1% vs 0%, p=0.16), and urinary tract infection (1.1% vs 1.1%, p=1.00).
Pediatric BT patients had twice the LOS compared to a matched group of pediatric T patients. There was no difference between the cohorts in ICU LOS, complications or mortality rate. When evaluating risk-stratified quality metrics such as LOS, concomitant burn injury should be incorporated.
创伤是儿童死亡的主要原因。烧伤涉及大量资源，尤其是在儿科患者中。我们假设，在儿科创伤患者中，与单纯创伤（T）患者相比，合并烧伤-创伤（BT）患者的住院时间（LOS）和死亡率更高。
查询小儿创伤质量改进计划（2014-2016 年），根据年龄、性别、入院时低血压、损伤类型和严重程度，将 BT 患者与 T 患者进行 1:2 的倾向评分匹配。
93 例 BT 患者与 186 例 T 患者匹配。匹配特征无差异。BT 患者的中位 LOS 较长（4 天比 2 天，p<0.001），死亡率无差异（1.1%比 1.1%，p=1.00），重症监护病房（ICU） LOS 无差异（3 天比 3 天，p=0.55），并发症包括压疮（0%比 1.1%，p=0.32）、深静脉血栓形成（0%比 0.5%，p=0.48）、四肢间隔综合征（1.1%比 0%，p=0.16）和尿路感染（1.1%比 1.1%，p=1.00）。
与匹配的儿科 T 患者相比，儿科 BT 患者的 LOS 增加了一倍。两组在 ICU LOS、并发症或死亡率方面无差异。在评估 LOS 等风险分层质量指标时，应考虑合并烧伤损伤。
