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三级护理中心电烧伤的变化趋势——流行病学与结果分析

Changing Trends In Electrical Burns From A Tertiary Care Centre - Epidemiology And Outcome Analysis.

作者信息

Arumugam P K, Thakur P, Sarabahi S

机构信息

Department of Burns, Plastic & Maxillofacial Surgery, VM Medical College & Safdarjung Hospital, Delhi, India.

出版信息

Ann Burns Fire Disasters. 2021 Dec 31;34(4):351-359.

Abstract

Electrical burn injuries result in significant mortality and morbidity. Most of these injuries are preventable. We conducted a retrospective analysis of various aspects of electrical injuries presenting to our center over a period of 1 year from September 2018 to August 2019. Demographic characteristics of patients along with burn characteristics and associated injuries were analysed. Outcomes including length of hospital stay, need for fasciotomy, amputation, renal failure and mortality were also analysed. A total of 6380 patients presented to our center during the study period, of which 471 (7.38%) had electrical burns. Total burn admissions were 1530, of which 283 (18.49%) patients were admitted with electrical burns. The mean age in our cohort was 25.31±12.76 years and mean TBSA was 29.22±23.81%. The most common cause of electrical burns was occupational (33.3%), followed by those that occurred on the rooftop of houses (31%). A historical comparison with data published from our center in 2011 showed a significant increase in occupational burns (18.72% vs. 33.3%) and rooftop electrical burns (8.21% vs. 31%), and a decrease in agriculture-related (42.46% vs. 9.1%) and domestic electrical burns (26.02% vs. 6.7%). There was also a significant rise in proportion of high voltage injuries (71.23% vs. 86.90%). Logistic regression analysis showed electric contact burn to be a risk factor for fasciotomy and limb gangrene. Risk factors for renal failure were age, percentage burn, electric contact burn and rural residence, and those for mortality were percentage burn and renal failure. Emphasis on preventive strategies, especially against occupational injuries and injuries occurring on rooftops, is necessary to prevent such devastating injuries.

摘要

电烧伤会导致显著的死亡率和发病率。这些损伤大多是可预防的。我们对2018年9月至2019年8月这1年期间到我们中心就诊的电损伤的各个方面进行了回顾性分析。分析了患者的人口统计学特征以及烧伤特征和相关损伤。还分析了包括住院时间、是否需要进行筋膜切开术、截肢、肾衰竭和死亡率等结果。在研究期间,共有6380名患者到我们中心就诊,其中471例(7.38%)为电烧伤。烧伤患者总入院人数为1530例,其中283例(18.49%)因电烧伤入院。我们队列中的平均年龄为25.31±12.76岁,平均烧伤总面积为29.22±23.81%。电烧伤最常见的原因是职业性的(33.3%),其次是发生在房屋屋顶的电烧伤(31%)。与我们中心2011年公布的数据进行历史比较显示,职业性烧伤(18.72%对33.3%)和屋顶电烧伤(8.21%对31%)显著增加,而与农业相关的烧伤(42.46%对9.1%)和家庭电烧伤(26.02%对6.7%)减少。高压损伤的比例也显著上升(71.23%对86.90%)。逻辑回归分析显示电接触烧伤是筋膜切开术和肢体坏疽的危险因素。肾衰竭的危险因素是年龄、烧伤百分比、电接触烧伤和农村居住情况,而死亡的危险因素是烧伤百分比和肾衰竭。必须强调预防策略,特别是针对职业性损伤和发生在屋顶的损伤,以预防此类毁灭性损伤。

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本文引用的文献

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Factors affecting mortality among victims of electrical burns.电烧伤受害者死亡率的影响因素。
Ulus Travma Acil Cerrahi Derg. 2017 May;23(3):223-229. doi: 10.5505/tjtes.2016.29166.
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Electrical burns: Highlights from a 5-year retrospective analysis.电烧伤:一项5年回顾性分析的要点
Ulus Travma Acil Cerrahi Derg. 2016 May;22(3):278-82. doi: 10.5505/tjtes.2015.55491.

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