Department of Burns and Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Scar Free Foundation Centre for Conflict Wound Research, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
Department of Burns and Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Burns. 2022 Dec;48(8):1783-1793. doi: 10.1016/j.burns.2022.06.009. Epub 2022 Jun 22.
Emerging evidence suggests that the pathophysiological impact of acute burn injuries may have chronic health consequences. We conducted a systematic review and meta-analysis to investigate the association between burn injuries and long-term mortality in patients surviving to initial discharge from hospital.
Medline and Embase databases were searched on 22 October 2021. Studies were eligible for inclusion if they compared long-term mortality amongst burn survivors to non-injured controls from the general population. When the same output metrics related to mortality were reported, meta-analyses were undertaken using a random effects model. Risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal tool.
Following an extensive literature search, six studies (seven articles) were identified for inclusion. They were predominantly based in high-income countries, with each comparing burns' survivors to matched non-injured controls from the general population. The four studies included in the meta-analysis had a combined unadjusted odds ratio of 2.65 (1.84 - 3.81; 95 % confidence interval) and adjusted mortality rate ratio of 1.59 (1.31 - 1.93; 95 % confidence interval). Thus, burn survivors demonstrated greater mortality rates when compared to their non-injured counterparts. Similar findings were illustrated in the remaining studies not included in the meta-analysis, with the exception of one study which found no significant difference between the two groups.
Our review suggests that acute burn injuries may be associated with greater long-term mortality rates (unadjusted and adjusted). The underlying mechanism is unclear and further work is required to establish the role of certain factors such as biological ageing processes, to improve outcomes for burn patients.
新出现的证据表明，急性烧伤的病理生理影响可能会对慢性健康产生后果。我们进行了系统评价和荟萃分析，以调查烧伤患者与从医院初次出院后长期死亡率之间的关系。
于 2021 年 10 月 22 日检索了 Medline 和 Embase 数据库。如果比较烧伤幸存者与一般人群中未受伤对照者的长期死亡率的研究，则符合纳入标准。当报告与死亡率相关的相同输出指标时，使用随机效应模型进行荟萃分析。使用 Joanna Briggs 研究所（JBI）的批判性评估工具评估偏倚风险。
经过广泛的文献搜索，确定了六项研究（七篇文章）纳入本研究。它们主要基于高收入国家，每个研究都将烧伤幸存者与一般人群中的匹配未受伤对照者进行比较。荟萃分析中包含的四项研究的未调整优势比为 2.65（1.84-3.81；95%置信区间），调整后的死亡率比为 1.59（1.31-1.93；95%置信区间）。因此，与未受伤的对照组相比，烧伤幸存者的死亡率更高。未纳入荟萃分析的其余研究也说明了类似的发现，但有一项研究发现两组之间无显著差异。
我们的综述表明，急性烧伤可能与更高的长期死亡率（未调整和调整）相关。其潜在机制尚不清楚，需要进一步研究确定某些因素（如生物老化过程）的作用，以改善烧伤患者的预后。
