Rahimpour Armein, Fox Nathan, Kahley Grant, Giangrosso Gerard V, Abdelgaber Karim, Bown Paul, Denning David A, Harrison Curtis, Rahman Barry
General Surgery, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Plastic and Reconstructive Surgery, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Cureus. 2024 Sep 18;16(9):e69658. doi: 10.7759/cureus.69658. eCollection 2024 Sep.
Introduction Burn injuries pose a significant public health challenge globally, with Appalachia facing unique obstacles due to its rugged terrain, economic disparities, and limited access to healthcare. Understanding mortality risk factors specific to Appalachian burn patients is crucial for optimizing treatment approaches in this underserved population. Materials and methods A retrospective analysis of burn patient data from Cabell Huntington Hospital's burn intensive care unit (BICU) over 13 years was conducted. Patient records were reviewed, and demographic and clinical variables were analyzed using descriptive statistics and logistic regression models. Results Among 1,104 Appalachian burn patients treated at Cabell Huntington Hospital's BICU between January 2010 and June 2023, advanced age, larger total body surface area (TBSA) burned, inhalation injuries, chronic obstructive pulmonary disease (COPD), and third-degree burns were significant predictors of mortality. Advanced age (p < 0.001, OR: 1.07), larger TBSA burned (p < 0.001, OR: 1.1), inhalation injuries (p < 0.001, OR: 8.34), COPD (p < 0.001, OR: 2.64), and third-degree burns (p < 0.001, OR: 6.45) were significant predictors of mortality. Gender, smoking history, diabetes mellitus (DM), and body mass index did not significantly differ between survivors and deceased patients. Discussion/conclusion Our findings underscore the importance of tailored interventions for Appalachian burn patients. Advanced age, pre-existing comorbidities, and burn severity significantly impact mortality risk, emphasizing the need for comprehensive care strategies. Specialized burn centers play a critical role in managing complex burn injuries in underserved regions. Addressing mortality risk factors identified in this study is essential for optimizing burn care outcomes in Appalachia. Tailored interventions and collaborative efforts are needed to improve survival rates and promote health equity for burn patients in underserved regions. Future research should explore additional factors influencing burn outcomes and assess disparities in access to specialized care services.
引言
烧伤是全球公共卫生面临的重大挑战，阿巴拉契亚地区因其崎岖的地形、经济差距和有限的医疗服务可及性而面临独特障碍。了解阿巴拉契亚烧伤患者特有的死亡风险因素对于优化这一服务不足人群的治疗方法至关重要。
材料与方法
对卡贝尔·亨廷顿医院烧伤重症监护病房（BICU）13年来的烧伤患者数据进行回顾性分析。查阅患者记录，并使用描述性统计和逻辑回归模型分析人口统计学和临床变量。
结果
在2010年1月至2023年6月期间在卡贝尔·亨廷顿医院BICU接受治疗的1104例阿巴拉契亚烧伤患者中，高龄、更大的烧伤总面积（TBSA）、吸入性损伤、慢性阻塞性肺疾病（COPD）和三度烧伤是死亡的重要预测因素。高龄（p < 0.001，OR：1.07）、更大的烧伤TBSA（p < 0.001，OR：1.1）、吸入性损伤（p < 0.001，OR：8.34）、COPD（p < 0.001，OR：2.64）和三度烧伤（p < 0.001，OR：6.45）是死亡的重要预测因素。幸存者和死亡患者在性别、吸烟史、糖尿病（DM）和体重指数方面无显著差异。
讨论/结论
我们的研究结果强调了针对阿巴拉契亚烧伤患者进行量身定制干预的重要性。高龄、既往合并症和烧伤严重程度显著影响死亡风险，强调了全面护理策略的必要性。专业烧伤中心在管理服务不足地区的复杂烧伤损伤方面发挥着关键作用。解决本研究中确定的死亡风险因素对于优化阿巴拉契亚地区的烧伤护理结果至关重要。需要量身定制的干预措施和协作努力，以提高服务不足地区烧伤患者的生存率并促进健康公平。未来的研究应探索影响烧伤结果的其他因素，并评估获得专科护理服务方面的差异。
