Yoneda Kazuhiro, Osuka Akinori, Ohnishi Shinya, Matsuura Hiroshi, Oda Jun
Department of Traumatology and Acute Critical Medicine Osaka University Suita Osaka Japan.
Department of Trauma, Critical Care Medicine and Burn Center Japan Community Healthcare Organization Chukyo Hospital Nagoya Aichi Japan.
Acute Med Surg. 2024 Jun 27;11(1):e970. doi: 10.1002/ams2.970. eCollection 2024 Jan-Dec.
When treating burn patients, some patients die in the chronic phase, even if they overcome the acute phase of the burn. To elucidate the timing of death and its underlying causes among burn patients.
Patients evaluated were admitted to our burn center between January 2015, and December 2019. Patient information, time, and cause of death were retrospectively collected from their medical records.
Among 342 admitted patients, 49 died. The time of death was as follows: within 24 h ( = 9), within 3 days ( = 7), within 1 week ( = 5), within 2 weeks ( = 4), within 3 weeks ( = 3), within 30 days ( = 6), within 60 days ( = 5), and after 60 days ( = 9). The causes of death within 3 days were hypoxic encephalopathy, extensive burns (>80%), severe heat stroke, and acute coronary syndrome. The causes of death after 3 days were sepsis, pneumonia, intestinal ischemia, pancreatitis, and worsening of chronic diseases. The mortality rate was similar for patients ≥65 years of age and those with a burn area of ≥20%, with both groups showing a particularly poor prognosis.
The timing of death in hospitalized burn patients showed a bimodal distribution as approximately 40% of patients who survived the resuscitation period died after 30 days. Elderly patients were at particularly high risk for mortality. In burn care, treatment planning should consider not only the short-term but also the long-term prognosis.
在治疗烧伤患者时,一些患者即使度过了烧伤急性期,仍会在慢性期死亡。旨在阐明烧伤患者的死亡时间及其潜在原因。
评估的患者于2015年1月至2019年12月期间入住我们的烧伤中心。从他们的病历中回顾性收集患者信息、死亡时间和原因。
在342例入院患者中,49例死亡。死亡时间如下:24小时内(n = 9)、3天内(n = 7)、1周内(n = 5)、2周内(n = 4)、3周内(n = 3)、30天内(n = 6)、60天内(n = 5)以及60天后(n = 9)。3天内的死亡原因是缺氧性脑病、大面积烧伤(>80%)、严重中暑和急性冠状动脉综合征。3天后的死亡原因是败血症、肺炎、肠道缺血、胰腺炎和慢性病恶化。65岁及以上患者和烧伤面积≥20%的患者死亡率相似,两组的预后都特别差。
住院烧伤患者的死亡时间呈双峰分布,约40%度过复苏期的患者在30天后死亡。老年患者的死亡风险尤其高。在烧伤护理中,治疗计划不仅应考虑短期预后,还应考虑长期预后。