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烧伤后住院康复时间预测因素的研究:一项烧伤模型系统研究

An Examination of Factors Predicting Inpatient Rehabilitation Stay After Burn Injury: A Burns Model System Study.

作者信息

Dellheim Vanessa, O'Neil Audrey M, Connolly Lori, Shepler Lauren J, McMullen Kara A, Kazis Lewis E, Kowalske Karen, Suman-Vejas Oscar E, Orton Caitlin, Stewart Barclay T, Ryan Colleen M, Schneider Jeffrey C

机构信息

Massachusetts General Hospital, Boston, MA, United States.

Richard M Fairbanks Burn Center, Indianapolis, IN, United States.

出版信息

J Burn Care Res. 2025 Jun 9. doi: 10.1093/jbcr/iraf108.

Abstract

Rehabilitation services often improve the functional recovery of people who have experienced burn injuries. However, characteristics associated with longer inpatient rehabilitation (IR) stays have not been well explored. This study aimed to examine patient and clinical factors associated with the length of IR stay. Adult participants in the Burn Model System National Database (1994-2022) discharged to IR following their hospital stay were included. A negative binomial regression analysis examined the association between IR days and demographic and injury characteristics. A p-value less than 0.05 was considered significant. The study included 585 participants who were 72% male with mean age of 46.1 years (SD 16.8), and mean burn size of 34.6% (20.5) total body surface area (TBSA). Average IR days were 22.8 (19.3). Characteristics associated with more IR days include TBSA (p-value <0.001), ventilator days (p-value <0.001), high- voltage electrical injury (p-value 0.021), ROM deficits (p-value 0.049), foot burns (0.008), and self-inflicted injury (p-value =0.002). Hand burns (p-value 0.008) and self-pay/philanthropy/other primary payor source (p-value <0.001) were the only factors in this study associated with less IR days. Study results demonstrate significant links between burn injury complexity factors and IR stay. Understanding how these factors affect length of IR stay post-burn injury will better help to inform rehabilitation care decisions. Results provide future opportunities for examination of anticipated IR LOS and factors guiding additional rehabilitation resources.

摘要

康复服务通常能改善烧伤患者的功能恢复情况。然而,与较长住院康复(IR)时间相关的特征尚未得到充分探索。本研究旨在探讨与IR住院时间相关的患者和临床因素。纳入了烧伤模型系统国家数据库(1994 - 2022年)中住院后出院接受IR治疗的成年参与者。采用负二项回归分析来检验IR天数与人口统计学和损伤特征之间的关联。p值小于0.05被认为具有统计学意义。该研究纳入了585名参与者,其中72%为男性,平均年龄46.1岁(标准差16.8),平均烧伤面积为全身表面积(TBSA)的34.6%(20.5)。平均IR天数为22.8天(19.3)。与更多IR天数相关的特征包括TBSA(p值<0.001)、使用呼吸机天数(p值<0.001)、高压电损伤(p值0.021)、关节活动度受限(p值0.049)、足部烧伤(0.008)和自残伤(p值 =0.002)。手部烧伤(p值0.008)和自费/慈善/其他主要支付来源(p值<0.001)是本研究中与较少IR天数相关的唯一因素。研究结果表明烧伤损伤复杂性因素与IR住院时间之间存在显著关联。了解这些因素如何影响烧伤后IR住院时间将有助于更好地为康复护理决策提供信息。研究结果为检查预期的IR住院时间和指导额外康复资源的因素提供了未来的机会。

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