老年烧伤患者就诊于大型烧伤中心急诊科：临床特点和结局。

Geriatric Burn Injuries Presenting to the Emergency Department of a Major Burn Center: Clinical Characteristics and Outcomes.

机构信息

Department of Emergency Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York.

Boston Trauma Institute, Department of Surgery, Boston University School of Medicine, Boston, Massachusetts.

出版信息

J Emerg Med. 2022 Aug;63(2):143-158. doi: 10.1016/j.jemermed.2022.01.016. Epub 2022 May 28.

DOI:10.1016/j.jemermed.2022.01.016

PMID:35637048

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9489596/

Abstract

BACKGROUND

Burn injuries in geriatric patients are common and may have significant associated morbidity and mortality. Most research has focused on the care of hospitalized patients after admission to burn units. Little is known about the clinical characteristics of geriatric burn victims who present to the emergency department (ED) and their ED assessment and management.

OBJECTIVE

Our aim was to describe the clinical characteristics and outcomes of geriatric patients presenting to the ED with burn injuries.

METHODS

We performed a comprehensive retrospective chart review on all patients 60 years and older with a burn injury presenting from January 2011 through September 2015 to a large, urban, academic ED in a hospital with a 20-bed burn center.

RESULTS

A total of 459 patients 60 years and older were treated for burn injuries during the study period. Median age of burn patients was 71 years, 23.7% were 80 years and older, and 56.6% were female. The most common burn types were hot water scalds (43.6%) and flame burns (23.1%). Median burn size was 3% total body surface area (TBSA), 17.1% had burns > 10% TBSA, and 7.8% of patients had inhalation injuries. After initial evaluation, 46.4% of patients were discharged from the ED. Among patients discharged from the ED, only 1.9% were re-admitted for any reason within 30 days. Of the patients intubated in the ED, 7.1% were extubated during the first 2 days of admission, and 64.3% contracted ventilator-associated pneumonia.

CONCLUSIONS

Better understanding of ED care for geriatric burn injuries may identify areas in which to improve emergency care for these vulnerable patients.

摘要

背景

老年人烧伤较为常见，可能会导致严重的发病率和死亡率。大多数研究都集中在烧伤患者住院后入住烧伤病房的护理上。对于在急诊科就诊的老年烧伤患者的临床特征及其急诊科评估和管理，知之甚少。

目的

我们旨在描述在急诊科就诊的老年烧伤患者的临床特征和结局。

方法

我们对 2011 年 1 月至 2015 年 9 月期间在一家拥有 20 张烧伤床位的烧伤中心的大型城市学术急诊室就诊的所有 60 岁及以上烧伤患者进行了全面的回顾性病历审查。

结果

在研究期间，共有 459 名 60 岁及以上的烧伤患者接受了治疗。烧伤患者的中位年龄为 71 岁，23.7%为 80 岁及以上，56.6%为女性。最常见的烧伤类型是热水烫伤（43.6%）和火焰烧伤（23.1%）。烧伤面积中位数为 3%的总体表面积（TBSA），17.1%的烧伤面积大于 10% TBSA，7.8%的患者有吸入性损伤。在初始评估后，46.4%的患者从急诊科出院。在从急诊科出院的患者中，只有 1.9%的患者在 30 天内因任何原因再次入院。在急诊科插管的患者中，7.1%的患者在入院后前 2 天内拔管，64.3%的患者患有呼吸机相关性肺炎。