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运用简化烧伤严重度指数和急性生理学与慢性健康状况评分系统 3 预测危重症烧伤患者的死亡率。

Predicting mortality for critically ill burns patients, using the Abbreviated Burn Severity Index and Simplified Acute Physiology Score 3.

机构信息

Resident of Plastic Surgery at Universidade Federal de São Paulo / Escola Paulista de Medicina (UNIFESP/EPM), Rua Botucatu, 740 - 2th floor, Sao Paulo, SP, Brazil.

Discipline of Plastic Surgery, Surgery Department, (UNIFESP/EPM), Brazil; MD, PhD degree Program on Translational Surgery at Universidade Federal de São Paulo / Escola Paulista de Medicina (UNIFESP/EPM), Rua Botucatu, 740 - 2th floor, Sao Paulo, SP, Brazil.

出版信息

Injury. 2022 Feb;53(2):453-456. doi: 10.1016/j.injury.2021.11.027. Epub 2021 Nov 15.

Abstract

INTRODUCTION

Reviewing the profile of patients admitted at the Burns Intensive Care Unit at São Paulo Hospital - UNIFESP, as well as the available literature, it becomes evident the need for tools able to predict those patients' outcomes. Distinct score models are used in different health centers, not only as prognostic models, but also as research and quality control tools. Amongst these prognostic scores, there are two strands, the burns specific scores - which consider the injury's characteristics - and the general critical patient's scores.

OBJECTIVE

This study aims to analyze the differences and tendencies in mortality prediction of two broadly used scores when applied to São Paulo Hospital's Burns Intensive Care Unit patients, ABSI - burns specific score - and SAPS 3 - general score for critical patients.

METHODS

This is an individual, observational, retrospective and comparative study, developed with medical records review. Both scores were applied to every patient admitted at São Paulo Hospital's Burns Intensive Care Unit from 2011 to 2016. Statistical analyses used the non-parametric test of Kolmogorov-Smirnov, a p-value <0.05 was considered significant.

RESULTS

122 patients were included, the average age was 34,4 years old. 70,5% of patients were male and 49% had a total body surface area burned of 20%. 27% of the patients died. Statistical analyses do not show significant differences between ABSI and SAPS3 mortality predictions for burns patients at this health center.

CONCLUSION

The study evidences that SAPS 3 score, frequently used at general Intensive Care Units, has a similar performance to ABSI score, which is specific for burns populations. ABSI score is easier to implement, as it is simpler and able to show instant results.

摘要

简介

回顾圣保罗医院烧伤重症监护病房(UNIFESP)收治患者的情况,并查阅相关文献,我们发现需要有工具来预测这些患者的预后。不同的医疗中心使用不同的评分模型,这些评分模型不仅可以作为预后模型,还可以作为研究和质量控制工具。在这些预后评分中,有两种评分,一种是烧伤专用评分,它考虑了损伤的特征;另一种是普通重症患者的评分。

目的

本研究旨在分析两种广泛应用于圣保罗医院烧伤重症监护病房患者的评分(烧伤专用评分 ABSI 和重症患者通用评分 SAPS 3)在死亡率预测方面的差异和趋势。

方法

这是一项个体、观察性、回顾性和比较研究,通过病历回顾进行。这两种评分都应用于 2011 年至 2016 年期间在圣保罗医院烧伤重症监护病房收治的所有患者。统计分析使用非参数 Kolmogorov-Smirnov 检验,p 值<0.05 认为有统计学意义。

结果

共纳入 122 例患者,平均年龄为 34.4 岁。70.5%的患者为男性,49%的患者烧伤总面积为 20%。27%的患者死亡。统计分析显示,该医疗中心的 ABSI 和 SAPS3 对烧伤患者死亡率的预测没有显著差异。

结论

本研究表明,在普通重症监护病房广泛使用的 SAPS 3 评分与 ABSI 评分(专门用于烧伤人群)的性能相似。ABSI 评分更易于实施,因为它更简单,能够立即得出结果。

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