Karray Rym, Chakroun-Walha Olfa, Mechri Folla, Salem Imen, Drira Hanen, Nasri Abdennour, Damak Ayman, Rekik Noureddine
Emergency Department, Habib bourguiba university hospital, Faculty of Medicine, Sfax University, Majida Boulila Avenue, Sfax, Tunisia.
Cardiac Surgery Department, Habib Bourguiba University Hospital, Faculty of Medicine, Sfax University, Sfax, Tunisia.
Eur J Trauma Emerg Surg. 2025 Jan 27;51(1):85. doi: 10.1007/s00068-025-02766-1.
Electrical injuries (EIs) represent a significant clinical challenge due to their complex pathophysiology and variable presentation, ranging from minor burns to severe internal organ damage. Despite their prevalence in both; domestic and occupational settings, there remains a rareness of systematic guidelines and comprehensive literature to aid clinicians in effectively managing these injuries. Understanding these factors is crucial for developing protocols that can mitigate the risk of delayed complications, such as cardiac arrhythmias, in patients who initially appear stable.
This study aims to elucidate the epidemiology, clinical outcomes, and predictors of severe presentation in EIs, providing insights to improve patient assessment and management strategies.
A retrospective study was conducted over 4 years. Data were collected from standardized medical records. The group of patients with severe complications included those who presented a life-threatening cardiac, respiratory, neurological, or biological impairment or died within the first 48 h of the EI.
We enrolled 118 cases of electrical injury (EI). Ages ranged from 4 to 82 years, with 31.3% under 15. EI incidence peaked in summer, with 63.5% being home accidents. High-voltage injuries occurred in 13.6%. The most common ED complaints were burns in children (59.5%) and trauma in adults (48.1%). ECG abnormalities correlated with tetany (p = 0.016), and palpitations (p = 0.014). Complications included cardiac arrest (n = 8), rhabdomyolysis (n = 23), and acute renal injury (n = 9). Severe EI was linked to respiratory distress and creatine kinase levels higher than ≥ 253 UI/l. A normal ECG within 1 h post-injury was correlated to a low risk of severe EI. At 2-year follow-up, 43.9% of survivors reported aesthetic sequelae, 25.3% had psychological disorders, and 7% of adults could not return to their previous occupations.
EIs are frequent, with diverse clinical presentations requiring multidisciplinary care. Awareness of potential delayed complications is essential, and prevention is crucial.
电击伤（EI）因其复杂的病理生理过程和多样的表现形式，从轻微烧伤到严重的内脏损伤，给临床治疗带来了重大挑战。尽管电击伤在家庭和职业环境中都很常见，但目前仍缺乏系统的指南和全面的文献来帮助临床医生有效管理这些损伤。了解这些因素对于制定能够降低延迟并发症风险的方案至关重要，例如对于最初看似稳定的患者预防心律失常。
本研究旨在阐明电击伤的流行病学、临床结局以及严重表现的预测因素，为改善患者评估和管理策略提供见解。
进行了一项为期4年的回顾性研究。数据从标准化医疗记录中收集。严重并发症患者组包括那些出现危及生命的心脏、呼吸、神经或生物损伤或在电击伤后48小时内死亡的患者。
我们纳入了118例电击伤病例。年龄范围为4至82岁，其中15岁以下者占31.3%。电击伤发生率在夏季达到峰值，63.5%为家庭事故。高压损伤占13.6%。急诊科最常见的主诉在儿童中是烧伤（59.5%），在成人中是创伤（48.1%）。心电图异常与手足搐搦（p = 0.016）和心悸（p = 0.014）相关。并发症包括心脏骤停（n = 8）、横纹肌溶解（n = 23）和急性肾损伤（n = 9）。严重电击伤与呼吸窘迫以及肌酸激酶水平高于≥253 UI/l有关。伤后1小时内心电图正常与严重电击伤风险低相关。在2年随访中，43.9%的幸存者报告有美学后遗症，25.3%有心理障碍，7%的成年人无法恢复到以前的职业。
电击伤很常见，其多样的临床表现需要多学科护理。认识到潜在的延迟并发症至关重要，预防是关键。
