老年人烧伤的流行病学和临床特征：武汉烧伤研究所 2554 例回顾性分析 15 年。
Epidemiological and clinical characteristics of older adults with burns: a 15-year retrospective analysis of 2554 cases in Wuhan Institute of Burns.
机构信息
Wuhan Institute of Burns, Tongren Hospital of Wuhan University (Wuhan Third Hospital), 241# Peng Liuyang Road, Wuhan, 430060, Wuchang District, China.
出版信息
BMC Geriatr. 2023 Mar 22;23(1):162. doi: 10.1186/s12877-023-03883-5.
BACKGROUND
With the increase of geriatric burns, it's urgent to summarize its characteristics. The aim of this study was to analyze the epidemiological and clinical characteristics of older adults with burns in a large center, and to provide suggestions for the prevention and treatment of geriatric burns.
METHODS
This retrospective study was conducted at Wuhan Institute of Burns which is the largest burn center in central China between 2004 to 2018. Demographic and clinical data of the 60 years or above older burn inpatients were collected from medical records, analyzed and compared among groups.
RESULTS
This study analyzed 2554 elderly burns, which included 50.9% in young geriatric group (60-69 years old), 32.9% in middle geriatric group (70-79 years old) and 16.2% in the oldest geriatric group (80 years old or above). The most common causes of elderly burns were flames (1081, 42.3%) and scalding (1041, 40.8%). Elderly burns with total body surface area (TBSA) of 0-9% accounted for 60.6% and the larger TBSA, the fewer number of patients. The majority of patients (70.5%) injured at home.The median of time interval from injury to admission was 7 h and the oldest geriatric group (24 h) was highest. One hundred and twenty-one cases (8.5%) were treated by cooling treatment, and 72.7% of these patients were treated less than 10 min. The median number of pre-injury diseases was one. Ninety patients (6.3%) had inhalation injury.The median length of stay (LOS) was 14 days.The median hospital cost was 10,410 CNY or 2137 CNY per % TBSA, which was correlated with TBSA, LOS, surgery, inhalation injury, number of pre-injury diseases and etiology. The mortality rate was 3.0% and correlated with TBSA, inhalation injury, pulmonary disease and Alzheimer's disease. The lethal area 50% (LA) for total admitted elderly burns was 78.3% TBSA (95% confidence interval [CI] = 69.8 ~ 89.9% TBSA).
CONCLUSION
Geriatric burns was still common and even increasing in central China, with flame burns and scalds the most common causes, majority of whom injured at home and often had problems such as few cooling treatment, improper emergency management and delayed admission. TBSA, etiology, pre-injury diseases and inhalation injury were the risk factors of length of stay, hospital cost and treatment outcomes.
背景
随着老年烧伤患者的增加，迫切需要总结其特点。本研究旨在分析大型烧伤中心老年烧伤患者的流行病学和临床特征，为老年烧伤的防治提供建议。
方法
本回顾性研究在武汉烧伤研究所进行，该研究所是中国中部最大的烧伤中心，时间范围为 2004 年至 2018 年。从病历中收集了 60 岁及以上住院老年烧伤患者的人口统计学和临床数据，并进行了组间分析比较。
结果
本研究共分析了 2554 例老年烧伤患者，其中年轻老年组（60-69 岁）占 50.9%，中老年组（70-79 岁）占 32.9%，最年长老年组（80 岁及以上）占 16.2%。老年烧伤的最常见原因是火焰（1081 例，42.3%）和烫伤（1041 例，40.8%）。烧伤总面积（TBSA）为 0-9%的老年烧伤患者占 60.6%，TBSA 越大，患者越少。大多数患者（70.5%）在家中受伤。受伤至入院的中位时间间隔为 7 小时，最年长老年组（24 小时）最高。121 例（8.5%）接受了冷却治疗，其中 72.7%的患者治疗时间不到 10 分钟。中位合并疾病数为 1 种。90 例（6.3%）有吸入性损伤。中位住院时间（LOS）为 14 天。中位住院费用为 10410 元人民币或每%TBSA 2137 元人民币，与 TBSA、LOS、手术、吸入性损伤、合并疾病数和病因有关。死亡率为 3.0%，与 TBSA、吸入性损伤、肺部疾病和阿尔茨海默病有关。总入院老年烧伤患者的 50%致死面积（LA）为 78.3%TBSA（95%置信区间[CI]为 69.8%~89.9%TBSA）。
结论
在中国中部地区，老年烧伤仍然很常见，甚至呈上升趋势，火焰烧伤和烫伤是最常见的原因，大多数患者在家中受伤，往往存在冷却治疗少、急救处理不当、入院延迟等问题。TBSA、病因、合并疾病和吸入性损伤是住院时间、住院费用和治疗结果的危险因素。
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