Zawacki B E, Azen S P, Imbus S H, Chang Y T
Ann Surg. 1979 Jan;189(1):1-5. doi: 10.1097/00000658-197901000-00001.
Burn mortality statistics may be misleading unless they account properly for the many factors which may influence outcome. In reviewing such factors in our patients, we identified age, total burn area, third degree burn area, prior bronchopulmonary disease, abnormal Pao2, and airway edema as the factors present on admission which best distinguished survivors from nonsurvivors. Using multifactorial probit analysis, we then calculated the contribution of each to the probability of fatal outcome. The resultant six-factor model significantly improved estimation of the probability of fatal outcome when compared to probit analysis based only on the traditional factors of age and total burn area. It also revealed a spectrum of mortality probabilities varying with the additional factors present. Although crucial in comparing different approaches to burn care, consideration of such prognostic factors will not eliminate the need for randomized treatment trials, because other factors, some of which are obscure, may also influence mortality rates in burned patients.
烧伤死亡率统计数据可能会产生误导,除非能恰当考虑到许多可能影响预后的因素。在回顾我们患者的这些因素时,我们确定年龄、烧伤总面积、三度烧伤面积、既往支气管肺部疾病、动脉血氧分压异常和气道水肿是入院时存在的因素,这些因素最能区分存活者和非存活者。然后,我们使用多因素概率分析计算了每个因素对致命结局概率的贡献。与仅基于年龄和烧伤总面积等传统因素的概率分析相比,所得出的六因素模型显著改善了对致命结局概率的估计。它还揭示了随其他因素存在而变化的一系列死亡概率。尽管在比较不同的烧伤治疗方法时至关重要,但考虑这些预后因素并不能消除进行随机治疗试验的必要性,因为其他因素(其中一些尚不清楚)也可能影响烧伤患者的死亡率。