Koenig V, Fochtmann-Frana A, Tratnig-Frankl P, Monai M, Joestl J
Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Private Clinic, Spitalgasse 19, 1090, Vienna, Austria.
Wien Klin Wochenschr. 2025 Sep 2. doi: 10.1007/s00508-025-02591-x.
High-voltage electrical injuries from train surfing pose a unique challenge, often involving severe burns and multisystem trauma. This study retrospectively analyzed train surfing injuries over 30 years, with a focus on trauma-associated diagnoses and comparing them to work-related high-voltage injuries.
A retrospective review of 87 high-voltage injury cases was conducted, including 30 train surfing and 57 work-related cases. Demographics, injury patterns, injury time, intensive care unit (ICU) stays, surgical interventions, Glasgow Coma Scale (GCS) scores, accident timing and trauma scores (Abbreviated Burn Severity Index (ABSI), Injury Severity Score (ISS), Abbreviated Injury Scale (AIS), National Advisory Committee for Aeronautics Score (NACA), Glasgow Outcome Scale (GOS)) were analyzed.
Train surfers were significantly younger (20.6 years vs. 36.0 years, p < 0.001) and sustained more severe burns (Total Body Surface Area (TBSA): 46.5% vs. 20.8%, p < 0.001). The ABSI (7.1 vs. 5.1, p < 0.01) and ISS (25.0 vs. 12.0, p < 0.001) were higher in train surfers, reflecting greater injury severity. The ICU stays were longer (56.1 days vs. 15.8 days, p < 0.001) and fasciotomies (86.7% vs. 53.0%, p < 0.01) and amputations (56.7% vs. 17.5%, p < 0.001) were more frequent. Train surfers exhibited worse metabolic parameters (base excess -4.49 vs. -0.7 mmol/L, p < 0.001; lactate 3.2 vs. 2.6 mmol/L, p < 0.05) and higher AIS scores for head and thoracic trauma. The GCS at the accident site was lower in train surfers (11.1 vs. 13.0, p = 0.10), indicating more severe initial impairment. Accidents predominantly occurred at night (69.9% of train surfing cases vs. 3.5% of work-related cases, p < 0.001). Mortality was significantly higher in the train surfing group (20.0% vs. 3.2%, p < 0.01).
Train surfing injuries involve extensive burns, severe multisystem trauma, and a higher surgical burden compared to work-related injuries. Their distinct injury patterns necessitate targeted prevention and specialized trauma care.
乘火车冲浪造成的高压电损伤带来了独特的挑战，常涉及严重烧伤和多系统创伤。本研究回顾性分析了30年来乘火车冲浪所致损伤，重点关注与创伤相关的诊断，并将其与工作相关的高压电损伤进行比较。
对87例高压电损伤病例进行回顾性研究，其中包括30例乘火车冲浪所致损伤和57例工作相关损伤。分析了人口统计学资料、损伤模式、损伤时间、重症监护病房（ICU）住院时间、手术干预、格拉斯哥昏迷量表（GCS）评分、事故发生时间和创伤评分（简化烧伤严重程度指数（ABSI）、损伤严重程度评分（ISS）、简明损伤定级标准（AIS）、美国国家航空咨询委员会评分（NACA）、格拉斯哥预后量表（GOS））。
乘火车冲浪者明显更年轻（20.6岁对36.0岁，p<0.001），烧伤更严重（总体表面积（TBSA）：46.5%对20.8%，p<0.001）。乘火车冲浪者的ABSI（7.1对5.1，p<0.01）和ISS（25.0对12.0，p<0.001）更高，反映出损伤更严重。ICU住院时间更长（56.1天对15.8天，p<0.001），筋膜切开术（86.7%对53.0%，p<0.01）和截肢术（56.7%对17.5%，p<0.001）更频繁。乘火车冲浪者的代谢参数更差（碱剩余-4.49对-0.7 mmol/L，p<0.001；乳酸3.2对2.6 mmol/L，p<0.05）以及头部和胸部创伤的AIS评分更高。乘火车冲浪者在事故现场的GCS更低（11.1对13.0，p = 0.10），表明初始损伤更严重。事故主要发生在夜间（乘火车冲浪病例的69.9%对工作相关病例的3.5%，p<0.001）。乘火车冲浪组的死亡率显著更高（20.
