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电烧伤及相关因素对三级烧伤病房住院时间的影响。

Electrical Burn and Associated Factors That Prolong In-patient Stay in a Level Three Burn Unit.

机构信息

Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia.

Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle. Cali, Colombia.

出版信息

J Burn Care Res. 2023 Sep 7;44(5):1241-1248. doi: 10.1093/jbcr/irad031.

Abstract

Electrical trauma is associated with significant morbidity and mortality, which have been reduced by improved medical care, as measured by the length of stay (LOS) as a marker for this population's quality of care. This paper will review the clinical and demographic characteristics, LOS in the hospital, and variables related to patients with electrical burns. A retrospective cohort study was conducted at a specialized burn unit in Southwest Colombia. Five hundred seventy-five electrical burn-related admissions from 2000 to 2016 were reviewed for the LOS and variables including patient-related (age, gender, marital status, education, and occupation), location of the accident (domestic vs labor-related), voltage, direct contact, arc, flash, flame, clinical presentation (burn surface area, depth, single or multiple organ injury, secondary infection, and abnormal labs), and treatment (surgical procedures and intensive care unit [ICU] admission). Univariate and bivariate analysis, with its 95% CI (confidence interval). We also performed a multiple logistic regression. LOS was correlated to males, age greater than 20 years, construction workers, high voltage injuries, severe burns by area and depth, infection, ICU admission, and multiple surgical procedures or extremity amputation. LOS due to electrical injury was observed to be significantly associated with the following variables, carpal tunnel release (OR [odds ratio]= 4.25, 95% CI [confidence interval] 1.70-5.20); amputation (OR = 2.81, 95% CI 1.60-5.10); infection (OR = 2.60, 95% CI 1.30-5.20); site of infection, mainly wound (OR = 1.30, 95% CI 1.10-1.44); associated injury (OR = 1.72, 95% CI 1.00-3.24); work or domestic accident (OR = 1.83, 95% CI 1.00-3.32); aged 20-40 years (OR = 1.41, 95% CI 1.00-2.10); CPK (OR = 1.40, 95% CI 1.00-2.00); and third-degree burns (OR = 1.55, 95% CI 1.00-2.80). Risk factors for LOS secondary to electrical injury should be appropriately addressed. Prevention at high-risk workplaces is imperative. Mitigating the injury with appropriate management of infection and timely surgical interventions play an essential role in the successful treatment of these patients.

摘要

电击伤会导致显著的发病率和死亡率,这一情况已经通过改善医疗护理得到了改善,住院时间(LOS)作为该人群护理质量的指标。本文将回顾电击伤患者的临床和人口统计学特征、住院时间以及与电击伤患者相关的变量。本研究是在哥伦比亚西南部的一家专门烧伤病房进行的回顾性队列研究。对 2000 年至 2016 年期间因电击伤住院的 575 例患者的 LOS 以及包括患者相关(年龄、性别、婚姻状况、教育程度和职业)、事故地点(家庭与工作相关)、电压、直接接触、电弧、闪光、火焰、临床表现(烧伤面积、深度、单个或多个器官损伤、继发感染和异常实验室检查)和治疗(手术程序和重症监护病房[ICU]入院)在内的变量进行了回顾。使用单变量和双变量分析,及其 95%置信区间(CI)。我们还进行了多变量逻辑回归。LOS 与男性、年龄大于 20 岁、建筑工人、高压伤、严重烧伤面积和深度、感染、ICU 入院和多次手术或四肢截肢有关。与电击伤 LOS 显著相关的变量包括腕管松解术(OR [比值比] = 4.25,95%CI [置信区间] 1.70-5.20);截肢(OR = 2.81,95%CI 1.60-5.10);感染(OR = 2.60,95%CI 1.30-5.20);感染部位,主要为伤口(OR = 1.30,95%CI 1.10-1.44);合并损伤(OR = 1.72,95%CI 1.00-3.24);工作或家庭事故(OR = 1.83,95%CI 1.00-3.32);年龄 20-40 岁(OR = 1.41,95%CI 1.00-2.10);CPK(OR = 1.40,95%CI 1.00-2.00);三度烧伤(OR = 1.55,95%CI 1.00-2.80)。应适当处理与电击伤 LOS 相关的危险因素。在高风险工作场所进行预防至关重要。通过适当管理感染和及时进行手术干预来减轻损伤,对这些患者的成功治疗起着至关重要的作用。

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