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低收入和中等收入国家会阴及生殖器烧伤的流行病学与转归:一项全球烧伤登记研究

The Epidemiology and Outcomes of Perineal and Genital Burn Injury in Low- and Middle- Income Countries: A Global Burn Registry Study.

作者信息

Panayi Adriana C, Didzun Oliver, Nnabuko Richard, Sjöberg Folke, Knoedler Samuel, Haug Valentin, Palackic Alen, Tapking Christian, Ewerbeck Nicolas, Bigdeli Amir K, Kneser Ulrich, Hundeshagen Gabriel

机构信息

Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.

Department of Plastic Surgery, National Orthopaedic Hospital, Enugu, Nigeria.

出版信息

J Plast Reconstr Aesthet Surg. 2024 Aug;95:17-20. doi: 10.1016/j.bjps.2024.05.034. Epub 2024 Jun 5.

Abstract

INTRODUCTION

The epidemiology, care, and outcomes of perineal and genital burns (PG) in high-income countries have been previously described, but an analysis of this topic in LMICs has yet to be performed. We use the World Health Organization's Global Burn Registry to fill this gap.

METHODS

The GBR was searched from inception to November 2023 to identify all burn patients, excluding cases from high-income countries. Demographics and mechanism of injury were retrieved. Primary outcomes were length of hospital stay (LOHS), surgical intervention, discharge with physical impairment, and mortality. A multivariate regression analysis was performed controlling for burnt total body surface area (TBSA), age, sex, inhalation injury, mechanism of burn and care center characteristics.

RESULTS

Of 9041 patients identified, 1213 (13.4 %) had PG burns with 136 (1.6 %) isolated to the PG region. PG patients had higher TBSA (p < 0.001) and more inhalation injury (p < 0.001). They had better access to rehabilitation and lower access to theater space for burns (p < 0.001). Multivariable analysis showed that PG patients had longer LOHS (p = 0.001), greater mortality (p < 0.001), were less likely to undergo surgery (p = 0.01) or be discharged home with physical impairment (p = 0.03).

CONCLUSION

Similarities and differences exist between high- and low/middle-income countries in terms of the patterns of injury, care, and recovery in patients with PG burns. The longer LOHS and higher mortality among PG patients, previously reported in high-income countries, are verified. This highlights the importance of greater vigilance when caring for such patients.

摘要

引言

高收入国家会阴部和生殖器烧伤(PG)的流行病学、护理及预后情况此前已有描述,但中低收入国家(LMICs)尚未对该主题进行分析。我们利用世界卫生组织的全球烧伤登记处来填补这一空白。

方法

检索全球烧伤登记处自创建至2023年11月期间的所有烧伤患者,排除高收入国家的病例。收集人口统计学数据和损伤机制。主要结局指标为住院时间(LOHS)、手术干预、出院时存在身体损伤以及死亡率。进行多变量回归分析,控制烧伤总面积(TBSA)、年龄、性别、吸入性损伤、烧伤机制及护理中心特征。

结果

在9041例确诊患者中,1213例(13.4%)有PG烧伤,其中136例(1.6%)仅累及PG区域。PG烧伤患者的TBSA更高(p<0.001),吸入性损伤更多(p<0.001)。他们获得康复治疗的机会更好,但用于烧伤治疗的手术室空间较少(p<0.001)。多变量分析显示,PG烧伤患者的住院时间更长(p=0.001),死亡率更高(p<0.001),接受手术的可能性更小(p=0.01),或出院时伴有身体损伤的可能性更小(p=0.03)。

结论

高收入国家与中低收入国家在PG烧伤患者的损伤模式、护理及康复方面存在异同。此前在高收入国家报道的PG烧伤患者住院时间更长及死亡率更高的情况得到了验证。这凸显了在护理此类患者时提高警惕的重要性。

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