Pais Michael-Alexander, Vasella Mauro, Matthes Oliver, Millesi Elena, Kobler Alexander, Breckwoldt Tabea, Reid Gregory, Naef Lukas, Hofmann Luzie, Watson Jennifer Ashley, Bühler Philipp Karl, Giovanoli Pietro, Kim Bong-Sung
Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
Department of Plastic and Reconstructive Surgery, BG Trauma Center Ludwigshafen, University of Heidelberg, Heidelberg, Germany.
Intern Emerg Med. 2025 Feb 12. doi: 10.1007/s11739-025-03887-6.
Severe burn injuries present significant global healthcare challenges, with outcomes significantly influenced by factors such as socioeconomic status, mental health conditions, and substance use, which vary across regions and healthcare systems. This study investigates the etiologies, treatment outcomes, and the impact of psychiatric conditions and controlled substance use on burn injuries in patients admitted to the intensive care unit at Switzerland's largest Burn Center. Data were retrospectively analyzed from 438 patients admitted to the University Hospital Zurich Burn Center ICU between 2016 and 2022. Variables assessed included baseline characteristics, burn etiologies, injury mechanisms, treatment modalities, complications, discharge outcomes, and mortality. Statistical analyses employed generalized linear models and logistic regression. Most burns occurred at home/leisure activities (43.4%), 21.2% at work. Pre-existing psychiatric conditions were present in 38.8% of patients, and 24.4% were under influence of controlled substances at the time of injury. These factors were associated with higher complication rates, increased surgeries, longer hospital stays, and lower survival rates. The overall in-hospital mortality rate was 15.8%, significantly linked to a history of controlled substance use. These findings highlight the significant impact of psychiatric conditions and use of controlled substances on burn injury outcomes, underscoring the importance of an interdisciplinary approach to treatment and management, particularly for patients with mental health and substance abuse histories.
严重烧伤给全球医疗保健带来了重大挑战,其治疗结果受到社会经济地位、心理健康状况和药物使用等因素的显著影响,这些因素在不同地区和医疗系统中存在差异。本研究调查了瑞士最大烧伤中心重症监护病房收治患者的烧伤病因、治疗结果以及精神疾病和管制药物使用对烧伤的影响。对2016年至2022年期间苏黎世大学医院烧伤中心重症监护病房收治的438例患者的数据进行了回顾性分析。评估的变量包括基线特征、烧伤病因、损伤机制、治疗方式、并发症、出院结果和死亡率。统计分析采用广义线性模型和逻辑回归。大多数烧伤发生在家中/休闲活动时(43.4%),21.2%发生在工作时。38.8%的患者存在既往精神疾病,24.4%的患者在受伤时受管制药物影响。这些因素与更高的并发症发生率、更多的手术、更长的住院时间和更低的生存率相关。总体住院死亡率为15.8%,与管制药物使用史显著相关。这些发现凸显了精神疾病和管制药物使用对烧伤治疗结果的重大影响,强调了跨学科治疗和管理方法的重要性,特别是对于有心理健康和药物滥用史的患者。